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General NPI Number Information
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NPI Number | 1033870456
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Entity Type | Individual
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Provider Name | MARIE CHARISSE IMPE NP
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Gender | Female
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Dates
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Enumeration Date | 01/07/2022
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Last Update Date | 03/17/2023
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Provider Practice Location Address
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Address Line | 5802 SARATOGA BLVD STE 200
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City | CORPUS CHRISTI
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State | TX
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Zip | 78414-4252
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Country | US
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Telephone | 361-696-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 5802 SARATOGA BLVD STE 200
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City | CORPUS CHRISTI
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State | TX
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Zip | 78414-4252
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Country | US
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Telephone | 361-696-6200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | F11200688
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 1026508
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1026508
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 363L00000X
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License Number State | TX
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