Individual
MR. NICHOLAS JACK MARINO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPNP-AC
Contact information
Practice address
109 MARYANN RD, TALLMADGE, OH 44278-1803
(330) 608-3863
Mailing address
109 MARYANN RD, TALLMADGE, OH 44278-1803
(330) 608-3863
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APRN.CNP.0030147
OH
363LP0200X
Pediatric Nurse Practitioner
APRN.CNP.0030147
OH
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
0030147
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0476233
—
OH
Enumeration date
11/02/2021
Last updated
01/12/2026
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