# MARCO NMN CRISCIONE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1134645922
- **Gender:** Man
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 0103010O | OK | Yes |
| 363LA2100X | Acute Care Nurse Practitioner | 0103010 | OK | — |
| 363LF0000X | Family Nurse Practitioner | 0103010 | OK | — |

## Other

- **Enumeration date:** 08/14/2017
- **Last updated:** 02/08/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0103010 | LICENSE | OK |
| 05 | — | 200741260A | — | OK |
| 01 | — | 2M8551 | MEDICARE | OK |