Individual
MR. IAN M MARCONI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN,RN, PMHNP-BC
Contact information
Practice address
10477 LIBERTY RD S, POWELL, OH 43065-9303
(614) 208-3740
Mailing address
10477 LIBERTY RD S, POWELL, OH 43065-9303
(614) 208-3740
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.333179
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.0030522
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
LE-00038409
OH
Other
Enumeration date
11/16/2021
Last updated
04/02/2026
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