Healthcare Provider Details

I. General information

NPI: 1336249515
Provider Name (Legal Business Name): MARCELLE PICK RNC MSN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 MARINA RD
YARMOUTH ME
04096-6783
US

IV. Provider business mailing address

3 MARINA RD
YARMOUTH ME
04096-6783
US

V. Phone/Fax

Practice location:
  • Phone: 207-846-6163
  • Fax: 207-846-6167
Mailing address:
  • Phone: 207-846-6163
  • Fax: 207-846-6167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR020461
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberR020461
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberF360452-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: