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General NPI Number Information
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NPI Number | 1053561381
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Entity Type | Individual
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Provider Name | MARIJKE B ORMEL ANP
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Gender | Female
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Dates
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Enumeration Date | 09/23/2008
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Last Update Date | 10/06/2008
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Provider Practice Location Address
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Address Line | 2233 STATE ROUTE 86
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City | SARANAC LAKE
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State | NY
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Zip | 12983-5644
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Country | US
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Telephone | 518-891-4141
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Fax | 518-897-2788
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Provider Business Mailing Address
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Address Line | 173 KIWASSA RD
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City | SARANAC LAKE
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State | NY
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Zip | 12983-2356
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Country | US
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Telephone | 518-891-0078
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Fax | 518-897-2423
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 304917
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License Number State | NY
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