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Individual
TRACEY A MARINO
Active
Individual
TRACEY A MARINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704259907
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F0113196
AANP CERTIFICATION
MI
Enumeration date
03/11/2013
Last updated
02/02/2022
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