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NPI Code Detail

MEDICARE: LISA ANN MARRERO FNPC

MEDICARE: LISA ANN MARRERO FNPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner71000814AIN

General Provider Information

NPI Number : 1073509071
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA ANN MARRERO FNPC
Provider Business Mailing Address
First Line : PO BOX 834
Second Line :
City : GOSHEN
State : IN
Zip : 46527-0834
Country : US
Telephone Number : 574-364-2592
Fax Number :
Provider Business Practice Location Address
First Line : 1953 WATERFALL DR STE A
Second Line :
City : NAPPANEE
State : IN
Zip : 46550-8961
Country : US
Telephone Number : 574-773-4101
Fax Number : 574-773-5483
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2005
Last Update Date : 03/03/2025

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Directions to “ LISA ANN MARRERO FNPC” Practice Location

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