Healthcare Provider Details

I. General information

NPI: 1124198692
Provider Name (Legal Business Name): MARIE ELIZABETH NAPOLITANO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 N 12TH AVE
CORNELIUS OR
97113-9029
US

IV. Provider business mailing address

9031 SW 42ND AVE
PORTLAND OR
97219-5201
US

V. Phone/Fax

Practice location:
  • Phone: 503-359-5925
  • Fax:
Mailing address:
  • Phone: 503-494-3873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number086006254N1
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: