Active NPI
Mary Kay Marciniak, RN,CDE
- Registered Nurse
- Cloquet, MN
National Provider Identifier
1235564436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN123847-3
- Practice address
- 512 Skyline Blvd
Cloquet, MN 55720 - Phone
- (218) 828-7661
- Fax
- (218) 828-7657
- NPI assigned
- Sep 6, 2013
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN123847-3 | MN | Primary |
Addresses
Primary practice location
512 Skyline Blvd
Cloquet, MN 55720
Mailing address
512 Skyline Blvd
Community Memorial Hospital
Cloquet, MN 55720
Phone (218) 828-7661
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN123847-3 | MN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378425600000",
"number": "1235564436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "512 SKYLINE BLVD",
"address_2": "COMMUNITY MEMORIAL HOSPITAL",
"city": "CLOQUET",
"state": "MN",
"postal_code": "55720",
"telephone_number": "218-828-7661",
"fax_number": "218-878-7657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 SKYLINE BLVD",
"city": "CLOQUET",
"state": "MN",
"postal_code": "55720",
"telephone_number": "218-828-7661",
"fax_number": "218-828-7657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCINIAK",
"first_name": "MARY",
"middle_name": "KAY",
"name_prefix": "Mrs.",
"credential": "RN,CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-06",
"last_updated": "2013-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MN",
"license": "RN123847-3",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cloquet, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.