Provider Demographics
NPI:1497086201
Name:HUSSEY, MARIAN ROSE (APRN)
Entity Type:Individual
Prefix:MS
First Name:MARIAN
Middle Name:ROSE
Last Name:HUSSEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MARIAN
Other - Middle Name:ROSE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:3451 PINE RIDGE RD BLDG 601
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-3922
Mailing Address - Country:US
Mailing Address - Phone:239-449-3072
Mailing Address - Fax:877-334-1886
Practice Address - Street 1:130 TAMIAMI TRL N STE 250
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6233
Practice Address - Country:US
Practice Address - Phone:239-263-1641
Practice Address - Fax:239-649-7473
Is Sole Proprietor?:No
Enumeration Date:2010-01-18
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1901942363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH200-556-65-901-0OtherFLORIDA DRIVERS LICENSE
FLARNP1901942OtherSTATE MEDICAL LICENSE