Marilyn Carol Edgeworth Tacoma, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

14929 Issued in WY

Practice address

1037 Morse Lee St
Evanston, WY 82930

Phone

(307) 679-1232

NPI assigned

Aug 11, 2015

Last updated

Aug 11, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439251200000",
    "number": "1164808382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 MORSE LEE ST",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "82930",
            "telephone_number": "307-679-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 MORSE LEE ST",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "82930",
            "telephone_number": "307-679-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACOMA",
        "first_name": "MARILYN",
        "middle_name": "CAROL EDGEWORTH",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2015-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WY",
            "license": "14929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Registered Nurse in Evanston, WY
• Providers in Evanston, WY by specialty
• Psychiatric/Mental Health Registered Nurse in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.