Marcie D Nellist-Johnson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704352421 Issued in MI

Practice address

11652 W Grand River Ave
Lowell, MI 49331-8465

Phone

(616) 301-8000

NPI assigned

Mar 12, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1457740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1285095604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11652 W GRAND RIVER AVE",
            "city": "LOWELL",
            "state": "MI",
            "postal_code": "493318465",
            "telephone_number": "616-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11652 W GRAND RIVER AVE",
            "city": "LOWELL",
            "state": "MI",
            "postal_code": "493318465",
            "telephone_number": "616-301-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELLIST-JOHNSON",
        "first_name": "MARCIE",
        "middle_name": "D",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-12",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MI",
            "license": "4704352421",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704352421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jon Monroe, R.PH.
• Courtney Elizabeth Muscat, DPT, CLT
• Peter Joseph Muszkiewicz, MT-BC
• Barbara Mutchler
• Cassandra Nanninga
• Rachel Neve, MT-BC
• Karen M Noreen, PHARMD
• Uchebike Nnagozie Nwankwo, MD
• Kenley Oosterhouse
• Diana M Painter, DPT

• All providers in Lowell, MI
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.