Provider Demographics
NPI:1336249515
Name:PICK, MARCELLE (RNC MSN NP)
Entity Type:Individual
Prefix:
First Name:MARCELLE
Middle Name:
Last Name:PICK
Suffix:
Gender:F
Credentials:RNC MSN NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MARINA RD
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6783
Mailing Address - Country:US
Mailing Address - Phone:207-846-6163
Mailing Address - Fax:207-846-6167
Practice Address - Street 1:3 MARINA RD
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6783
Practice Address - Country:US
Practice Address - Phone:207-846-6163
Practice Address - Fax:207-846-6167
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER020461363LP0200X, 363LX0001X
NYF360452-1363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEDEAOtherMP0026989
MEUX2708Medicare PIN
MES77588Medicare UPIN