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NPI Code Detail

MEDICARE: MS. MARIKA J MARLAND PMH-NP

MEDICARE: MS. MARIKA J MARLAND PMH-NP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner052281ME

General Provider Information

NPI Number : 1669658381
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARIKA J MARLAND PMH-NP
Provider Business Mailing Address
First Line : 62 ELM ST
Second Line :
City : PORTLAND
State : ME
Zip : 04101-3091
Country : US
Telephone Number : 207-773-7811
Fax Number : 207-773-0633
Provider Business Practice Location Address
First Line : 62 ELM ST
Second Line :
City : PORTLAND
State : ME
Zip : 04101-3091
Country : US
Telephone Number : 207-773-7811
Fax Number : 207-773-0663
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2008
Last Update Date : 11/06/2020

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