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General NPI Number Information
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NPI Number | 1528675733
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Entity Type | Individual
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Provider Name | MARCELLA ALENE MINER DNP, APRN
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Gender | Female
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Dates
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Enumeration Date | 09/30/2020
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 303 N JACKSON ST
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City | MORRISON
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State | IL
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Zip | 61270-3042
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Country | US
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Telephone | 815-772-4003
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Fax |
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Provider Business Mailing Address
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Address Line | 202 LAKESIDE DR
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City | ERIE
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State | IL
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Zip | 61250-9615
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Country | US
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Telephone | 309-230-5183
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.022013
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License Number State | IL
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