MARISSA DRAKE (NPI# 1124438734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124438734 |
| Entity Type | Individual |
| Full Name | MARISSA DRAKE |
| Credential | CNP |
| Practice Address |
3809 42nd Ave S Minneapolis MN 55406-3503 |
| Mailing Address |
4720 Grand Ave S Apt 2 Minneapolis MN 55419-5430 |
| Practice Telephone | 6122733000 |
| Mailing Telephone | 6123064002 |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2017-04-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WM0705X |
Registered Nurse Specialization: Medical-Surgical |
R 185046-6 | MN | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R 185046-6 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3809 42ND AVE S |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55406-3503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972579670 | Angela Dhruvan | Family Medicine | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2006-02-23 |
| 1689010357 | Jodi Lynn Johnson | Registered Nurse | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2013-05-21 |
| 1780942078 | Deqa Yassin Mohamed | Family Medicine | 3809 42nd Ave S, Minneapolis, MN 55406 | 2012-04-25 |
| 1093005498 | Gennadiy Vasilyevich Shevchenko | Psychiatry & Neurology | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2011-04-19 |
| 1538492103 | Jennifer Lynn Nickell | Pharmacist | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2009-09-14 |
| 1598921108 | Katharine Jones Plosser | Physician Assistant | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2008-08-03 |
| 1922271857 | Sandeep Kalola | Family Medicine | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2008-04-11 |
| 1346432218 | Fairview Clinics | Clinic/Center | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2007-08-15 |
| 1932328226 | Louisa Paul | Family Medicine | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2007-04-24 |
| 1851436539 | Fairview Hiawatha Pharmacy Mtm | Non-Pharmacy Dispensing Site | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2007-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286221 | Hoa Bui | Pharmacist | 4547 Hiawatha, Minneapolis, MN 55406 | 2020-08-17 |
| 1184263253 | Carrie Shannon Nightshade | Acupuncturist | 3706 E 42nd Street, Minneapolis, MN 55406 | 2020-01-06 |
| 1164060059 | Deborah Owen | Acupuncturist | 3706 E 42nd St, Minneapolis, MN 55406 | 2019-12-11 |
| 1194290593 | Noelle Therese Wolf | Counselor | 2637 27th Ave S # 229, Minneapolis, MN 55406 | 2018-10-11 |
| 1255819819 | Ayan Osman Ali | Behavior Technician | 3355 Haiwatha Ave Suite 100, Minneapolis, MN 55406 | 2018-08-04 |
| 1881188597 | Lydia Joy Allison | Massage Therapist | 2933 29th Ave. S., Minneapolis, MN 55406 | 2018-06-15 |
| 1497261770 | Carroll Lee Beaty | Massage Therapist | 2801 42nd Ave. So., Minneapolis, MN 55406 | 2017-12-21 |
| 1578082798 | Capitol Cafe LLC | Home Delivered Meals | 2417 E Franklin Ave, Capitol Cafe, Minneapolis, MN 55406 | 2017-09-19 |
| 1851823942 | Safia Abdulkadir Mohamud | Contractor | 2740 Minnehaha Ave Suit 100, Minneapolis, MN 55406 | 2017-03-29 |
| 1881051944 | Sos Transportation LLC | Non-emergency Medical Transport (VAN) | 3355 Haiwatha Ave Suit 100, Minneapolis, MN 55406 | 2016-01-20 |
| Find all providers in zip 55406 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639786312 | Peter Wahl | Nurse Practitioner | 4652 Lyndale Ave S, Minneapolis, MN 55419-5302 | 2020-09-28 |
| 1356951552 | Madelyn Jayne Argo | Nurse Practitioner | 1720 Victory Memorial Dr, Minneapolis, MN 55412-1239 | 2020-08-03 |
| 1356963789 | Kersten Larayne Bailey | Nurse Practitioner | 2958 Lincoln St Ne, Minneapolis, MN 55418-2236 | 2020-05-07 |
| 1649804519 | Ifrah Abdi Abdullahi | Nurse Practitioner | 620 E Franklin Ave Apt 413, Minneapolis, MN 55404-3293 | 2020-02-28 |
| 1821645342 | Kelsey Middlestaedt | Nurse Practitioner | 2525 Chicago Ave Ste 32-t5, Minneapolis, MN 55404-4518 | 2019-08-20 |
| 1720546773 | Erika Lindsey Kuis | Nurse Practitioner | 918 W Lake St, Minneapolis, MN 55408-2857 | 2019-03-08 |
| 1437639614 | Kelly Usitalo | Nurse Practitioner | 913 E 26th Street, Piper Building Suite 401, Minneapolis, MN 55407 | 2018-08-17 |
| 1588176028 | Sylvie Adjoko Gaba | Nurse Practitioner | 100 South Fifth Street 19th Floor, Minneapolis, MN 55402-5199 | 2017-10-24 |
| 1336664804 | Heidi M Morrisey | Nurse Practitioner | 800 East 28th St W, Minneapolis, MN 55407 | 2017-08-07 |
| 1275073181 | Yellow Coriander, Psc | Nurse Practitioner | 60 South 6th Street, Suite 2800, Minneapolis, MN 55402 | 2017-02-27 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55406 |
Please comment or provide details below to improve the information on MARISSA DRAKE.
| 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.