Individual
MS. DANA L MARINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1241 E DYER RD STE 145, SANTA ANA, CA 92705-5694
(888) 306-0615
Mailing address
1226 COLORADO AVE SE, GRAND RAPIDS, MI 49506-3916
(616) 890-3981
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704202282
MI
363LF0000X
Family Nurse Practitioner
4704202282
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704202282
BOARD OF NURSING
MI
Enumeration date
08/19/2008
Last updated
02/21/2017
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