Provider Demographics
NPI:1376610188
Name:EIPPERLE, MARILYN KAY (DNP, MSN, RN, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:KAY
Last Name:EIPPERLE
Suffix:
Gender:F
Credentials:DNP, MSN, RN, FNP-BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14394 NINE MILE ROAD
Mailing Address - Street 2:
Mailing Address - City:KALEVA
Mailing Address - State:MI
Mailing Address - Zip Code:49645-0333
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14394 9 MILE ROAD
Practice Address - Street 2:
Practice Address - City:KALEVA
Practice Address - State:MI
Practice Address - Zip Code:49645-0333
Practice Address - Country:US
Practice Address - Phone:231-362-3460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704117524363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily