Provider Demographics
NPI:1851686232
Name:MARSELLA, VALERIE LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:LYNN
Last Name:MARSELLA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:LYNN
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:280 SMITH N AVE 700
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2424
Mailing Address - Country:US
Mailing Address - Phone:651-241-3000
Mailing Address - Fax:651-241-8778
Practice Address - Street 1:280 SMITH N AVE 700
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2424
Practice Address - Country:US
Practice Address - Phone:651-241-3000
Practice Address - Fax:651-241-8778
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN10946OtherMN MEDICAL LICENSE