Healthcare Provider Details

I. General information

NPI: 1962502674
Provider Name (Legal Business Name): MARIANNE GOLDYN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COMMUNITY SUPPORT SERVICES INC 150 CROSS STREET
AKRON OH
44311
US

IV. Provider business mailing address

COMMUNITY SUPPORT SERVICES INC 150 CROSS STREET
AKRON OH
44311
US

V. Phone/Fax

Practice location:
  • Phone: 330-253-9388
  • Fax: 330-376-6726
Mailing address:
  • Phone: 330-253-9388
  • Fax: 330-376-6726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberCOA02474NS
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: