KATHLEEN MARMORINE (NPI# 1356370993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356370993 |
| Entity Type | Individual |
| Full Name | KATHLEEN MARMORINE |
| Practice Address |
Highway 1 Box 497 Red Lake MN 56671-0497 |
| Practice Telephone | 2186793912 |
| Practice Fax Number | 2186790181 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2007-11-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R 138537-1 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BC/BS OF MN | 387K5MA | 01 |
| Street Address |
HIGHWAY 1 BOX 497 |
| City | RED LAKE |
| State | MN |
| Zip Code | 56671-0497 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902886427 | Mark W Sellers | Pharmacist | Highway 1, Red Lake, MN 56671 | 2006-01-19 |
| 1063447605 | Michael Anthony P Borromeo | Internal Medicine | Highway 1, Ihs Box 165, Red Lake, MN 56671-0165 | 2006-07-12 |
| 1548290950 | Mark Douglas Cunningham | Family Medicine | Highway 1, Red Lake, MN 56671-0249 | 2006-07-03 |
| 1073543484 | Tracy Brower | Nurse Practitioner | Highway 1, Red Lake, MN 56671-0249 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063030419 | Red Lake Homeless Shelter Inc. | Case Management | 15855 Main Ave, Red Lake, MN 56671 | 2020-07-13 |
| 1376026153 | Children's Healing Center | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 25060 Hwy 1 East, Red Lake, MN 56671 | 2018-09-08 |
| 1003332057 | Red Lake Detention Outpatient | Substance Abuse Rehabilitation Facility | 25064 Highway 1 East, Red Lake, MN 56671 | 2017-08-21 |
| 1831642214 | Jennifer Franke | Pharmacist | 24760 Hospital Rd., Red Lake, MN 56671 | 2016-08-02 |
| 1538445978 | Hoaibac Nguyen | Pharmacist | 24760 Hospital Rd, Red Lake, MN 56671 | 2011-10-31 |
| 1639466048 | Red Lake Comprehensive Health Services | Dental Hygienist | 24809 Hospital Drive, Highway 1, Redlake, MN 56671 | 2011-07-06 |
| 1821391822 | Jill Christine Andersen | Physical Therapist | Hwy 1 Hospital Dr. Box 497, Red Lake, MN 56671 | 2010-12-13 |
| 1871802934 | Elizabeth Vivian Rose | Dentist | 24760 Hospital Dr., Red Lake, MN 56671 | 2010-10-06 |
| 1225202625 | Redlake Chemical Health Program Group Home | Substance Abuse Rehabilitation Facility | 15797 Main Avenue, Redlake, MN 56671 | 2008-04-16 |
| 1104029388 | Shannon Carl Nelson | General Acute Care Hospital | Highway 1 Box 497, Red Lake, MN 56671 | 2007-06-06 |
| Find all providers in zip 56671 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184280687 | Bruce James Chaffee | Nurse Practitioner | Red Lake Hospital, 24760 Hospital Drive, Red Lake, MN 56671-5667 | 2019-05-10 |
| 1720495302 | Kari Lynn Josefson | Nurse Practitioner | 24760 Hospital Drive, Red Lake, MN 56671 | 2014-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466368 | Amalia Jo Folland Harvey | Nurse Practitioner | 19883 Evensong Ct, Farmington, MN 55024-8688 | 2020-10-29 |
| 1710586235 | Jackelyn Laura Peterson | Nurse Practitioner | 10101 Bren Rd E Unit 345, Minnetonka, MN 55343-0060 | 2020-10-26 |
| 1578162509 | Mckenzie Mcadaragh | Nurse Practitioner | 10924 Girard Curve, Bloomington, MN 55431 | 2020-10-21 |
| 1861091704 | Morgan Rohl | Nurse Practitioner | 117 12th Ave Nw Apt 2, Rochester, MN 55901-2787 | 2020-10-21 |
| 1063010304 | Kalie R Mccauley | Nurse Practitioner | 11452 Brook Rd Nw, Elk River, MN 55330-8739 | 2020-10-09 |
| 1659978930 | Sarah Jean Mudge | Nurse Practitioner | 350 Harbor Dr, Duluth, MN 55802-2600 | 2020-10-08 |
| 1285231621 | Karlu Dorleh | Nurse Practitioner | 14151 Territorial Rd Unit 212, Maple Grove, MN 55369-5725 | 2020-10-08 |
| 1447857669 | Kimberly Dawn Bursch-tewalt | Nurse Practitioner | 11884 237th Ave Nw, Elk River, MN 55330-8255 | 2020-10-01 |
| 1639786312 | Peter Wahl | Nurse Practitioner | 4652 Lyndale Ave S, Minneapolis, MN 55419-5302 | 2020-09-28 |
| 1568078616 | Joanna Kay Rehm | Nurse Practitioner | 3025 Eagandale Pl Apt 338, Eagan, MN 55121-1236 | 2020-09-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.