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General NPI Number Information
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NPI Number | 1275293342
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Entity Type | Individual
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Provider Name | LIANE MICHELE MARCOTTE PMHNP
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Gender | Female
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Dates
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Enumeration Date | 12/30/2021
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Last Update Date | 09/07/2022
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Provider Practice Location Address
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Address Line | 755 W CARMEL DR STE 206
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City | CARMEL
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State | IN
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Zip | 46032-5878
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Country | US
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Telephone | 317-702-1600
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Fax | 317-836-1520
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Provider Business Mailing Address
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Address Line | 755 W CARMEL DR STE 206
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City | CARMEL
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State | IN
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Zip | 46032-5878
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Country | US
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Telephone | 317-804-3696
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Fax | 317-836-1520
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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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 | 71012964B
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License Number State | IN
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