Healthcare Provider Details

I. General information

NPI: 1548610215
Provider Name (Legal Business Name): MARINETTE N ZIBI PMHNP, DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARINETTE N GARRISON

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 02/09/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4531 32ND ST
MOUNT RAINIER MD
20712-1613
US

IV. Provider business mailing address

4531 32ND ST
MOUNT RAINIER MD
20712-1613
US

V. Phone/Fax

Practice location:
  • Phone: 240-253-3912
  • Fax:
Mailing address:
  • Phone: 240-253-3912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN 1031756
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP1031756
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR207867
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: