Individual
MARISSA AUTUMN MARINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1102 HIGHWAY 315 BLVD, WILKES BARRE, PA 18702-6943
(570) 235-1470
(570) 550-9256
Mailing address
1102 HIGHWAY 315 BLVD, WILKES BARRE, PA 18702-6943
(570) 235-1470
(570) 550-9256
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN638114
PA
363LF0000X
Family Nurse Practitioner
Primary
SP025286
PA
Other
Enumeration date
02/12/2022
Last updated
02/12/2022
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