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General NPI Number Information
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NPI Number | 1942579289
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Entity Type | Individual
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Provider Name | MICHELLE L MARINO CRNP
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Gender | Female
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Dates
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Enumeration Date | 12/15/2011
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Last Update Date | 10/06/2024
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Provider Practice Location Address
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Address Line | 130 N. MCKEAN ST. SUITE 204
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City | KITTANNING
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State | PA
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Zip | 16201
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Country | US
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Telephone | 724-302-5969
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Fax | 724-204-1946
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Provider Business Mailing Address
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Address Line | PO BOX 10526
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City | PITTSBURGH
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State | PA
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Zip | 15235-0526
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Country | US
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Telephone | 724-302-5969
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Fax | 724-204-1946
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP023522
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License Number State | PA
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