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General NPI Number Information
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NPI Number | 1104161116
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Entity Type | Individual
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Provider Name | MARCIA ELISE MCGINNIS APRN
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Gender | Female
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Dates
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Enumeration Date | 12/02/2012
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 5905 GRANDEL BLVD
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City | LOUISVILLE
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State | KY
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Zip | 40258-3099
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Country | US
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Telephone | 502-489-7351
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Fax |
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Provider Business Mailing Address
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Address Line | 101 S. FIFTH STREET SUITE 2500
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City | LOUISVILLE
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State | KY
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Zip | 40202-3066
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Country | US
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Telephone | 574-546-1900
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Fax | 574-546-1999
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3007793
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 3007793
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License Number State | KY
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