MEDICARE: MARIEL PRICE RN. MSN, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP3492	AZ

General Provider Information

NPI Number	:	1144556150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIEL PRICE RN. MSN, FNP-BC

Provider Business Mailing Address
First Line	:	624 W NATAL CIR
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85210-7593
Country	:	US
Telephone Number	:	602-999-1009
Fax Number	:

Provider Business Practice Location Address
First Line	:	624 W NATAL CIR
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85210-7593
Country	:	US
Telephone Number	:	602-999-1009
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2009
Last Update Date	:	10/26/2009

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