Provider Demographics
NPI:1669930186
Name:FOISY, MARCELLA ADRIENNE
Entity type:Individual
Prefix:
First Name:MARCELLA
Middle Name:ADRIENNE
Last Name:FOISY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7310 E RILEY ALEXANDER CIR
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-7725
Mailing Address - Country:US
Mailing Address - Phone:907-521-0888
Mailing Address - Fax:907-357-8547
Practice Address - Street 1:7310 E RILEY ALEXANDER CIR
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-7725
Practice Address - Country:US
Practice Address - Phone:907-521-0888
Practice Address - Fax:907-357-8547
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 310400000X
AK101241310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No251S00000XAgenciesCommunity/Behavioral Health