Healthcare Provider Details

I. General information

NPI: 1427074848
Provider Name (Legal Business Name): MARIE M CILIBERTO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 WHEATON WAY STE 202
BREMERTON WA
98310-4300
US

IV. Provider business mailing address

1341 SIDNEY AVE
PORT ORCHARD WA
98366-3113
US

V. Phone/Fax

Practice location:
  • Phone: 360-373-1772
  • Fax:
Mailing address:
  • Phone: 360-876-5725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP30002126
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: