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General NPI Number Information
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NPI Number | 1245845247
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Entity Type | Individual
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Provider Name | CALLIE MARZULLI APRN
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Gender | Female
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 1331 UNION AVE
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City | MEMPHIS
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State | TN
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Zip | 38104-3513
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Country | US
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Telephone | 901-866-8811
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Fax |
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Provider Business Mailing Address
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Address Line | 1211 UNION AVE STE 330
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City | MEMPHIS
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State | TN
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Zip | 38104-6655
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 28181
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 28181
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License Number State | TN
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