MARILYN DOERMANN KELLUM - NPI 1659472702 - Nurse Practitioner in Ann Arbor, MI

Q: What is Marilyn Kellum's NPI number?

The NPI number for Marilyn Kellum is 1659472702. It was assigned to this individual provider in the NPPES registry on September 25, 2006.

Q: What is Marilyn Kellum's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Marilyn Kellum was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Marilyn Doermann Kellum NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARILYN DOERMANN KELLUM (NPI 1659472702) is an individual adult health provider in Ann Arbor, Michigan, licensed in Michigan (4704119985) and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1659472702

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameMARILYN DOERMANN KELLUM

Location Address207 FLETCHERAnn Arbor, MI 48109-1050

Mailing Address207 FletcherAnn Arbor, MI 48109-1050 · (734) 764-2080 · Fax (734) 763-7505

Phone(734) 764-2080

Fax(734) 763-7505

Sole ProprietorNo

Enumeration DateSeptember 25, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1659472702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in MI · 4704119985

207 FLETCHER, Ann Arbor, MI 48109

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Other Identifiers 3

Medicare ID-Type UnspecifiedON56780002MI

Other5008602570MI · Bcbs Mi

Medicare UPINP75792

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

IRENE BIRUTA KOSS RPH

Pharmacist