Individual
MARISA LYNN LARIVIERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1044 BELMONT AVE, YOUNGSTOWN, OH 44504-1006
(330) 480-3658
(330) 480-3439
Mailing address
4135 BOARDMAN-CANFIELD ROAD, SUITE 101, CANFIELD, OH 44406-7010
(330) 286-5330
(330) 286-5396
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN229276
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2274088
—
OH
01
—
430066463
MEDICARE RAILROAD
OH
Enumeration date
06/08/2006
Last updated
03/18/2019
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