Active NPI
Ileana Despina Marin, LPN
- Licensed Practical Nurse
- Sells, AZ
National Provider Identifier
1124207386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- VN 224671
- Practice address
- Hwy 86 and Topawa Road
Sells, AZ 85634 - Phone
- (520) 383-7200
- NPI assigned
- Oct 24, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | VN 224671 | CA | Primary |
Addresses
Primary practice location
Hwy 86 and Topawa Road
Sells, AZ 85634
Mailing address
7900 S J Stock Rd
Tucson, AZ 85746-7012
Phone (520) 295-2503
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| VN 224671 | CA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193184000000",
"number": "1124207386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7900 S J STOCK RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857467012",
"telephone_number": "520-295-2503",
"fax_number": "520-295-2676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HWY 86 AND TOPAWA ROAD",
"city": "SELLS",
"state": "AZ",
"postal_code": "85634",
"telephone_number": "520-383-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARIN",
"first_name": "ILEANA",
"middle_name": "DESPINA",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-24",
"last_updated": "2007-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "CA",
"license": "VN 224671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sells, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.