Provider Demographics
NPI:1447663992
Name:DU, MARIANNE (FNP)
Entity type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:DU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4565 STATEN ISLAND CT
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-4715
Mailing Address - Country:US
Mailing Address - Phone:972-974-2338
Mailing Address - Fax:
Practice Address - Street 1:4565 STATEN ISLAND CT
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-4715
Practice Address - Country:US
Practice Address - Phone:972-974-2338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125316363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily