Michelle Marotzke, LPN
Individual provider Active NPI Licensed Practical Nurse · Vesta, MN
NPI 1669778973 · NPPES record last updated Feb 3, 2011
Key facts
- NPI
- 1669778973
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- L051211-6 (MN)
- Practice address
- 32644 Evergreen Ave
Vesta, MN 56292-1151 - Phone
- (507) 762-3096
- NPI assigned
- Feb 3, 2011
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| L051211-6 | MN | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | L051211-6 | MN | Yes |
Addresses
Primary practice location
32644 Evergreen Ave
Vesta, MN 56292-1151
Mailing address
32644 Evergreen Ave
Vesta, MN 56292-1151
Phone (507) 762-3096
Other providers in Vesta, MN
All providers in Vesta, MN · Licensed Practical Nurse in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.