Individual provider Active NPI

Renee S. Marlette, FNP, MSN

  • Family Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1861685265
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
214863-4405 Issued in UT
Practice address
100 N Medical Dr
Hematology/Oncology Service Line
Salt Lake City, UT 84113-1103
Phone
(801) 662-4700
NPI assigned
Aug 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 214863-4405 UT Primary

Addresses

Primary practice location

100 N Medical Dr
Hematology/Oncology Service Line
Salt Lake City, UT 84113-1103

Mailing address

100 N Medical Dr
Hematology/Oncology Service Line
Salt Lake City, UT 84113-1103
Phone (801) 662-4700

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
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
214863-4405UTMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1861685265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N MEDICAL DR",
            "address_2": "HEMATOLOGY/ONCOLOGY SERVICE LINE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MEDICAL DR",
            "address_2": "HEMATOLOGY/ONCOLOGY SERVICE LINE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLETTE",
        "first_name": "RENEE",
        "middle_name": "S.",
        "credential": "FNP, MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-20",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "214863-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; 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.