Healthcare Provider Details

I. General information

NPI: 1669768578
Provider Name (Legal Business Name): MARLAINE F REGISTE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2011
Last Update Date: 10/10/2020
Certification Date: 10/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 G ST NW STE 800
WASHINGTON DC
20005-6705
US

IV. Provider business mailing address

1200 G ST NW STE 800
WASHINGTON DC
20005-6705
US

V. Phone/Fax

Practice location:
  • Phone: 850-656-2006
  • Fax:
Mailing address:
  • Phone: 202-972-3639
  • Fax: 773-373-1955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2220382
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP2220382
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024174737
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN1045029
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: