Basic Information
Provider Information
NPI: 1982070017
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCGEE
FirstName: MARIANNE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 701 PARK AVE
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 554151623
CountryCode: US
TelephoneNumber: 6128733000
FaxNumber:  
Practice Location
Address1: 701 PARK AVE
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 554151623
CountryCode: US
TelephoneNumber: 6128733000
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/12/2015
LastUpdateDate: 10/09/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XR173538-7MNN Nursing Service ProvidersRegistered Nurse 
363LW0102XCNP 4076MNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health

ID Information
IDTypeStateIssuerDescription
CNP407601MNLICENSEOTHER


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