| Marcia S Kells, RN CNP | |
|
240 Willow St, Tyler, MN 56178-1166 | |
| (507) 247-5921 | |
| (507) 247-5184 |
| Full Name | Marcia S Kells |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 240 Willow St, Tyler, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164498804 | NPI | - | NPPES |
| 863387800 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | R0790585 (Minnesota) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 0790585 (Minnesota) | Primary |
| Entity Name | Avera Tyler |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1801840517 PECOS PAC ID: 9638088537 Enrollment ID: O20031103000411 |
| Entity Name | Tyler Medical Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649223439 PECOS PAC ID: 1557252533 Enrollment ID: O20040320000679 |
| Entity Name | Appleton Area Health |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1578590626 PECOS PAC ID: 7618952565 Enrollment ID: O20060504000767 |
| Entity Name | Appleton Area Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730126673 PECOS PAC ID: 7618952565 Enrollment ID: O20060818000114 |
| Entity Name | Avera Tyler |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801840517 PECOS PAC ID: 9638088537 Enrollment ID: O20170630001868 |
| Mailing Address | Practice Location Address |
|---|---|
| Marcia S Kells, RN CNP 240 Willow St, Tyler, MN 56178-1166 Ph: (507) 247-5921 | Marcia S Kells, RN CNP 240 Willow St, Tyler, MN 56178-1166 Ph: (507) 247-5921 |