MARISSA LYNNAE MAXHAM PTA NPI 1205405859

NPI Information

NPI: 1205405859
Provider Name: MARISSA LYNNAE MAXHAM, PTA
Classification: Physical Medicine & Rehabilitation - 2081P2900X
Entity Type: Individual

Specialization: Pain Medicine

Address:
701 SHADWELL AVE
FLORA, IL
ZIP 62839
Phone: (618) 662-8361
Get Directions

Marissa Lynnae Maxham, PTA is a pain medicine physical medicine rehabilitation in Flora, IL. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. Marissa Lynnae Maxham, PTA NPI is 1205405859. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

701 SHADWELL AVE
FLORA, IL
ZIP 62839-310
Phone: (618) 662-8361

The enumeration date for this NPI number is 6/18/2021 and was last updated on 6/18/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2081P2900X	Physical Medicine & Rehabilitation	Pain Medicine	160008997	ILLINOIS	Yes
2	2081H0002X	Physical Medicine & Rehabilitation	Hospice and Palliative Medicine	160.008997	ILLINOIS	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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