Healthcare Provider Details

I. General information

NPI: 1548943962
Provider Name (Legal Business Name): MARIANAS REPRODUCTIVE INSTITUTE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2023
Last Update Date: 04/17/2024
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 BEACH ROAD SUITE 101
SAIPAN MP
96950
US

IV. Provider business mailing address

P.O. BOX 5640-CHRB
SAIPAN MP
96950-5555
US

V. Phone/Fax

Practice location:
  • Phone: 670-783-1367
  • Fax:
Mailing address:
  • Phone: 670-783-1367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0006X
TaxonomyAmbulatory Fertility Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. KAREN AUDREY BUETTNER
Title or Position: PRESIDENT/OFFICE MANAGER
Credential: R.N.
Phone: 670-783-1367