Mahan, Marissa Paige

Mahan, Marissa Paige is an individual health care provider with primary practice located at 101 E Plummer Blvd , Chatham IL 62629-8047. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mahan, Marissa Paige can be contacted via phone (217) 483-3487.

Contact Information

Primary practice address
101 E Plummer Blvd Chatham IL 62629-8047
Phone: (217) 483-3487
Fax: (217) 483-8150
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2020014749 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209021387 Illinois

Profile Details

NPI number 1215531264
LBN Legal business name Mahan, Marissa Paige
Credentials DNP, FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2020
Last updated May 20th, 2024 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215531264 NPPES
Illinois Other 041443199 RN LICENSE

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