Individual
NICOLE RUTH MARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
400 E 3RD ST, ESSENTIA HEALTH DULUTH CLINIC, DULUTH, MN 55805-1951
(218) 786-3900
Mailing address
400 E 3RD ST, ESSENTIA HEALTH DULUTH CLINIC, DULUTH, MN 55805-1951
(218) 786-3900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11105
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11105
LICENSE
MN
Enumeration date
02/09/2012
Last updated
12/02/2015
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