Provider Demographics
NPI:1447436530
Name:MARX, CHERYL M
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:M
Last Name:MARX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LINVILLE DR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-2129
Mailing Address - Country:US
Mailing Address - Phone:859-987-3600
Mailing Address - Fax:859-987-9074
Practice Address - Street 1:9 LINVILLE DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-2129
Practice Address - Country:US
Practice Address - Phone:859-987-3600
Practice Address - Fax:859-987-9074
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0630133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered