# MS. CAYLYNN ANN WALLACE-MARCELLE

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

## Provider details

- **NPI number:** 1861558835
- **Gender:** F
- **Credential:** ARNP, CPNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0200X | Pediatric Nurse Practitioner | 955 | MN | Yes |
| 363LP0200X | Pediatric Nurse Practitioner | R180936-5 | MN | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 1809365 | MN | — |

## Other

- **Enumeration date:** 12/27/2006
- **Last updated:** 09/13/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1861558835 | — | MN |