Individual
KAREN MARZELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTIONIER
Contact information
Practice address
130 TOWN CENTER DR STE 200, TROY, MI 48084-1744
(248) 740-0670
(248) 740-0668
Mailing address
20952 E 12 MILE RD, SUITE 200, SAINT CLAIR SHORES, MI 48081-3200
(586) 771-4820
(586) 771-6620
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704123587
MI
363L00000X
Nurse Practitioner
Primary
4704123587
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB9133
RAILROAD MEDICARE
MI
Enumeration date
12/01/2006
Last updated
01/30/2018
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