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General NPI Number Information
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NPI Number | 1023356656
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Entity Type | Individual
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Provider Name | JOANN ELIZABETH MARINKOVICH-DAVIDSON FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/16/2013
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 1500 S LAKE PARK AVE SP402
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City | HOBART
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State | IN
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Zip | 46342-6638
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Country | US
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Telephone | 219-945-4488
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Fax | 219-947-6015
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Provider Business Mailing Address
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Address Line | 8558 BROADWAY
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City | MERRILLVILLE
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State | IN
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Zip | 46410-7032
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Country | US
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Telephone | 219-392-7084
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Fax | 219-703-6854
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71004356A
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License Number State | IN
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