Provider Demographics
NPI:1992530240
Name:ZEIS, MARLENA (RN)
Entity type:Individual
Prefix:
First Name:MARLENA
Middle Name:
Last Name:ZEIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MARLENA
Other - Middle Name:
Other - Last Name:MCGATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 710
Mailing Address - Street 2:
Mailing Address - City:CASSELTON
Mailing Address - State:ND
Mailing Address - Zip Code:58012-0710
Mailing Address - Country:US
Mailing Address - Phone:701-799-9030
Mailing Address - Fax:
Practice Address - Street 1:2101 ELM ST N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2498
Practice Address - Country:US
Practice Address - Phone:701-232-3241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR32051163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse