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NPI Code Detail

MEDICARE: NICOLE LYNN MARNELL DNP, PNP

MEDICARE: NICOLE LYNN MARNELL DNP, PNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner144364AK

General Provider Information

NPI Number : 1316501802
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE LYNN MARNELL DNP, PNP
Provider Business Mailing Address
First Line : 4600 ABBOTT RD
Second Line :
City : ANCHORAGE
State : AK
Zip : 99507-4314
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4600 ABBOTT RD
Second Line :
City : ANCHORAGE
State : AK
Zip : 99507-4314
Country : US
Telephone Number : 907-348-2101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2019
Last Update Date : 04/30/2019

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