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General NPI Number Information
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NPI Number | 1144201708
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Entity Type | Individual
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Provider Name | MARY ANN MARRS CNP
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Gender | Female
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 7220 S HIGHWAY 16
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City | RAPID CITY
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State | SD
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Zip | 57702-8708
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Country | US
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Telephone | 605-341-1414
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Fax | 605-341-7062
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Provider Business Mailing Address
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Address Line | 7220 S HIGHWAY 16 PO BOX 6850
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City | RAPID CITY
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State | SD
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Zip | 57702-8708
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Country | US
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Telephone | 605-341-1414
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Fax | 605-341-7062
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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 | R029403
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | SD-CNP CP000412
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License Number State | SD
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