Provider Demographics
NPI:1518576891
Name:ROSS, MARCELLA ANN (MSN, APRN, AGCNS-BC)
Entity Type:Individual
Prefix:
First Name:MARCELLA
Middle Name:ANN
Last Name:ROSS
Suffix:
Gender:F
Credentials:MSN, APRN, AGCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4825 W COUNTY ROAD 500 N
Mailing Address - Street 2:
Mailing Address - City:NORTH VERNON
Mailing Address - State:IN
Mailing Address - Zip Code:47265-7344
Mailing Address - Country:US
Mailing Address - Phone:812-350-1256
Mailing Address - Fax:
Practice Address - Street 1:2400 E. 17TH STREET
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201
Practice Address - Country:US
Practice Address - Phone:812-375-3229
Practice Address - Fax:812-376-5937
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28131551A364SC2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC2300XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistChronic Care