Doctor Name: | TRACEY A MARINO |
NPI Number: | 1801137229 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 4704259907 |
Business Practice Address: | 7870 W. Us 2 Schoolcraft Memorial Hospital Manistique, MI - 49854 |
Business Phone Number: | 9063413200 |
Business Fax Number: | 9063413189 |
Mailing Address: | 7870 W. Us 2, Schoolcraft Memorial Hospital MANISTIQUE |
State: | MI |
Postal Code: | 49854 |
Phone Number: | 9063413200 |
Fax Number: | 9063413189 |
NPI Enumeration Date: | 03/11/2013 |
NPI Last Update Date: | 02/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 4704259907 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |