Provider Demographics
NPI:1669658381
Name:MARLAND, MARIKA J (PMH-NP)
Entity Type:Individual
Prefix:MS
First Name:MARIKA
Middle Name:J
Last Name:MARLAND
Suffix:
Gender:F
Credentials:PMH-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 ELM ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-3091
Mailing Address - Country:US
Mailing Address - Phone:207-773-7811
Mailing Address - Fax:207-773-0633
Practice Address - Street 1:62 ELM ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-3091
Practice Address - Country:US
Practice Address - Phone:207-773-7811
Practice Address - Fax:207-773-0663
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME052281363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health