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NPI Code Detail

MEDICARE: MRS. MARIE JUNETTE METHELLUS ARNP

MEDICARE: MRS. MARIE JUNETTE METHELLUS ARNP
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
1363LF0000XFamily Nurse PractitionerAPRN9246196FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760770929
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARIE JUNETTE METHELLUS ARNP
Provider Business Mailing Address
First Line : 1819 W TENNESSEE ST
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32304-3356
Country : US
Telephone Number : 850-576-0147
Fax Number :
Provider Business Practice Location Address
First Line : 1819 W TENNESSEE ST
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32304-3356
Country : US
Telephone Number : 850-576-0147
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2011
Last Update Date : 05/21/2020

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