# MARISSA HUMPHREY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1598992794
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 23357 | MS | — |
| 207L00000X | Anesthesiology Physician | MD214825 | OR | Yes |
| 207R00000X | Internal Medicine Physician | 253540 | NY | — |

## Other

- **Enumeration date:** 06/15/2009
- **Last updated:** 09/06/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 06457521 | — | MS |
| 01 | — | P01454807 | RAILROAD MEDICARE PTAN | MS |