# MARLEE GOMM DICRISTOFANO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1043675994
- **Gender:** F
- **Credential:** BSN, RN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WC1500X | Community Health Registered Nurse | 4826371-3102 | UT | — |
| 163WL0100X | Lactation Consultant (Registered Nurse) | 4826371-3102 | UT | — |
| 163WN1003X | Nutrition Support Registered Nurse | 4826371-3102 | UT | — |
| 163WP0807X | Child & Adolescent Psychiatric/Mental Health Registered Nurse | 4826371-3102 | UT | Yes |

## Other

- **Enumeration date:** 12/19/2015
- **Last updated:** 12/20/2015