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Individual

MARJORIE MAINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
100 COMMUNITY DR, SUITE 102, TOBYHANNA, PA 18466-8985
(570) 839-8754
(570) 839-1079
Mailing address
3336 MOUNTAIN LAUREL DR, EAST STROUDSBURG, PA 18301-8124
(570) 844-0125

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SP014990
PA
363LP0200X
Pediatric Nurse Practitioner
F380966
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP024964
PA

Other

Enumeration date
10/01/2014
Last updated
11/25/2022
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