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NPI Code Detail

MEDICARE: MRS. MARIELLEN ANGELA SPEAKER FNP

MEDICARE: MRS. MARIELLEN ANGELA SPEAKER FNP
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
1363L00000XNurse PractitionerAP113975TX
2363LF0000XFamily Nurse Practitioner674802TX
3363LF0000XFamily Nurse PractitionerAP113975TX

General Provider Information

NPI Number : 1457336265
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARIELLEN ANGELA SPEAKER FNP
Provider Business Mailing Address
First Line : PO BOX 846098
Second Line :
City : DALLAS
State : TX
Zip : 75284-6098
Country : US
Telephone Number : 903-606-6400
Fax Number : 903-606-1522
Provider Business Practice Location Address
First Line : 214 E HOUSTON ST
Second Line :
City : TYLER
State : TX
Zip : 75702-8131
Country : US
Telephone Number : 903-593-1892
Fax Number : 903-533-1776
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2005
Last Update Date : 09/08/2023

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Directions to “ MRS. MARIELLEN ANGELA SPEAKER FNP” Practice Location

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