Individual
MARISSA MALLARI MAGTANONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
665 RHONE CT, GLEN BURNIE, MD 21061-4820
(410) 760-4128
Mailing address
665 RHONE CT, GLEN BURNIE, MD 21061-4820
(410) 760-4128
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R160195
MD
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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