Healthcare Provider Details

I. General information

NPI: 1497086201
Provider Name (Legal Business Name): MARIAN ROSE HUSSEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIAN ROSE TAYLOR APRN

II. Dates (important events)

Enumeration Date: 01/18/2010
Last Update Date: 10/06/2022
Certification Date: 10/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 TAMIAMI TRL N STE 250
NAPLES FL
34102-6233
US

IV. Provider business mailing address

3451 PINE RIDGE RD BLDG 601
NAPLES FL
34109-3922
US

V. Phone/Fax

Practice location:
  • Phone: 239-263-1641
  • Fax: 239-649-7473
Mailing address:
  • Phone: 239-449-3072
  • Fax: 877-334-1886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1901942
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1901942
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: