Healthcare Provider Details

I. General information

NPI: 1649094442
Provider Name (Legal Business Name): TONYA SUZETTE MARRERO MSN, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2024
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 A AVE NE STE 201
CEDAR RAPIDS IA
52402-4854
US

IV. Provider business mailing address

3490 LEMA DR
SPRING HILL FL
34609-2814
US

V. Phone/Fax

Practice location:
  • Phone: 213-559-1652
  • Fax: 813-336-8829
Mailing address:
  • Phone: 309-232-3245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number905015
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11050986
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG194454
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number10068005
License Number StateOR
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number905015
License Number StateNV
# 6
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number257830
License Number StateAK
# 7
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9315934
License Number StateFL
# 8
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number899151
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: