Individual
MARISA A. CIPKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2301 S BROAD ST, 1ST FLOOR, PHILADELPHIA, PA 19148-3542
(215) 952-9323
(215) 952-1246
Mailing address
2301 S BROAD ST, 1ST FLOOR, PHILADELPHIA, PA 19148-3542
(215) 952-9323
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
L1-0044487
DE
367500000X
Certified Registered Nurse Anesthetist
Primary
RN616927
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103230277
—
PA
05
—
1386199982
—
DE
Enumeration date
08/24/2016
Last updated
02/02/2026
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