Individual
MARISSA MICHAEL MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
6780 MAYFIELD RD, MAYFIELD HEIGHTS, OH 44124-2203
(440) 312-4500
Mailing address
6559 WILSON MILLS RD, CLEVELAND, OH 44143-6402
(440) 449-1540
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
17067
OH
Other
Enumeration date
02/17/2015
Last updated
02/17/2015
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