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NPI Code Detail

MEDICARE: LORI ANN MARIETTA ACNS

MEDICARE: LORI ANN MARIETTA ACNS
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
1163W00000XRegistered Nurse259463OH
2364SA2200XAdult Health Clinical Nurse Specialist11388-NSOH

General Provider Information

NPI Number : 1760788053
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI ANN MARIETTA ACNS
Provider Business Mailing Address
First Line : 6100 WHIPPLE AVE NW
Second Line :
City : NORTH CANTON
State : OH
Zip : 44720-7618
Country : US
Telephone Number : 330-244-8118
Fax Number : 330-244-8329
Provider Business Practice Location Address
First Line : 6100 WHIPPLE AVE NW
Second Line :
City : NORTH CANTON
State : OH
Zip : 44720-7618
Country : US
Telephone Number : 330-244-8118
Fax Number : 330-244-8329
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2011
Last Update Date : 02/12/2018

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Directions to “ LORI ANN MARIETTA ACNS” Practice Location

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