Provider Demographics
NPI:1831330497
Name:MARCELLA, KATHERINE H (PNP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:H
Last Name:MARCELLA
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2938
Mailing Address - Country:US
Mailing Address - Phone:940-566-5437
Mailing Address - Fax:940-320-2709
Practice Address - Street 1:1103 N ELM ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2938
Practice Address - Country:US
Practice Address - Phone:940-566-5437
Practice Address - Fax:940-320-2709
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX606596363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
2082209-PCOtherPNP CERTIFICATION