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Individual

LAURE MARINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
301-6 GREAT TEAYS BLVD, SCOTT DEPOT, WV 25560
(304) 757-6999
(304) 757-3252
Mailing address
301-6 GREAT TEAYS BLVD, SCOTT DEPOT, WV 25560
(304) 757-6999
(304) 757-3252

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
51372
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001719728
MS BCBS
WV
01
7538749
AETNA
WV
05
9600195001
WV
Enumeration date
02/08/2006
Last updated
11/09/2012
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