Individual provider Active NPI

Carlie A Dell, MSN, APNP, FNP-C

  • Family Nurse Practitioner
  • Marinette, WI
National Provider Identifier
1780291401
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704321194 Issued in MI
Practice address
2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone
(715) 735-5225
NPI assigned
Sep 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10531-33 WI
Family Nurse Practitioner 363LF0000X 4704321194 MI Primary

Addresses

Primary practice location

2820 Roosevelt Rd
Marinette, WI 54143-3834

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222

Other practice location 1

744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-7864

Other practice location 2

1636 Industrial Pkwy N
Marinette, WI 54143-3703
Phone (920) 445-7373

Other identifiers 1

IdentifierTypeStateIssuer
F09200219OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS

Other names 1

  • Carlie A Harms Former name

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)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10531-33WIMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1601164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1780291401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 ROOSEVELT RD",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541433834",
            "telephone_number": "715-735-5225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "744 S Webster Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013505",
            "country_code": "US",
            "telephone_number": "920-433-7864",
            "fax_number": "920-433-6090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1636 Industrial Pkwy N",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541433703",
            "country_code": "US",
            "telephone_number": "920-445-7373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELL",
        "first_name": "CARLIE",
        "middle_name": "A",
        "credential": "MSN, APNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-27",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "10531-33",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704321194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS",
            "identifier": "F09200219",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLIE",
            "last_name": "HARMS",
            "middle_name": "A",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marinette, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.