Healthcare Provider Details
I. General information
NPI: 1548589328
Provider Name (Legal Business Name): ABBEY J MARAKA DNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/19/2010
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7237 BAY RD
RHINELANDER WI
54501-9467
US
IV. Provider business mailing address
7237 BAY RD
RHINELANDER WI
54501-9467
US
V. Phone/Fax
- Phone: 920-200-8500
- Fax: 949-883-4408
- Phone: 920-200-8500
- Fax: 949-883-4408
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | 148841 |
| License Number State | WI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 1606674 |
| License Number State | WI |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 4081-33 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: