Marcella Mosey

Individual provider Active NPI Licensed Practical Nurse · Port Austin, MI

NPI 1629638424 · NPPES record last updated Jun 14, 2019

Key facts

NPI
1629638424
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
4703055745 (MI)
Practice address
3200 Oak Beach Rd
Port Austin, MI 48467-9767
Phone
(989) 424-8082
NPI assigned
Jun 14, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4703055745MIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703055745 MI Yes

Addresses

Primary practice location

3200 Oak Beach Rd
Port Austin, MI 48467-9767

Mailing address

3200 Oak Beach Rd
Port Austin, MI 48467-9767

Other providers in Port Austin, MI

All providers in Port Austin, MI · Licensed Practical Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.