Individual
MARILYN DOERMANN KELLUM
Active
Individual
MARILYN DOERMANN KELLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704119985
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5008602570
BCBS MI
MI
Enumeration date
09/25/2006
Last updated
07/08/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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