Healthcare Provider Details

I. General information

NPI: 1356478382
Provider Name (Legal Business Name): JUDY A MARINELLI MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 11/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 EXEMPLA CIR
LAFAYETTE CO
80026-3370
US

IV. Provider business mailing address

525 PINE ST
FREDERICK CO
80530-8038
US

V. Phone/Fax

Practice location:
  • Phone: 720-536-7826
  • Fax:
Mailing address:
  • Phone: 303-833-4348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: