Healthcare Provider Details

I. General information

NPI: 1457554040
Provider Name (Legal Business Name): CARRIE ELIZABETH MARRARA R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7721 CASTLE ROCK DR NE
WARREN OH
44484-1408
US

IV. Provider business mailing address

7721 CASTLE ROCK DR NE
WARREN OH
44484-1408
US

V. Phone/Fax

Practice location:
  • Phone: 330-609-7518
  • Fax:
Mailing address:
  • Phone: 330-609-7518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number318990
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: