Healthcare Provider Details

I. General information

NPI: 1912422064
Provider Name (Legal Business Name): ANGELA ANN MARSELLA PHARMD, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA A MARSELLA PHARMD

II. Dates (important events)

Enumeration Date: 08/10/2017
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 N PAULINE ST
MEMPHIS TN
38104-1005
US

IV. Provider business mailing address

232 S YATES RD
MEMPHIS TN
38120-2263
US

V. Phone/Fax

Practice location:
  • Phone: 901-523-8990
  • Fax:
Mailing address:
  • Phone: 334-447-8007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number19076-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: