Healthcare Provider Details

I. General information

NPI: 1073459277
Provider Name (Legal Business Name): MARNEECO LOETTE FERRELL CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15001 HEALTH CENTER DR
BOWIE MD
20716-1017
US

IV. Provider business mailing address

4214 DAY LILY DR
BOWIE MD
20720-4295
US

V. Phone/Fax

Practice location:
  • Phone: 240-677-0700
  • Fax:
Mailing address:
  • Phone: 240-505-8988
  • Fax: 240-505-8988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number168238
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: