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General NPI Number Information
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NPI Number | 1366227464
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Entity Type | Individual
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Provider Name | MARISSA LEE TRZASKOMA APRN
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Gender | Female
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 146 W 5TH ST
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-2901
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Country | US
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Telephone | 330-382-0165
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Fax | 330-382-0275
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Provider Business Mailing Address
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Address Line | 146 W 5TH ST
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-2901
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Country | US
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Telephone | 330-382-0165
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Fax | 330-382-0275
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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 | SP028667
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.512692
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 629333
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0034922
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License Number State | OH
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