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Individual

JOHN D MARINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
1585 S RANGE AVE, DENHAM SPRINGS, LA 70726-5201
(225) 791-0002
Mailing address
DEPT 960139, OKLAHOMA CITY, OK 73196-0139
(877) 485-4474

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
05610 APRN
LA
363LF0000X
Family Nurse Practitioner
100696 RN
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1799190
LA
01
P00913286
RRMCARE THRU DSUC
LA
Enumeration date
12/10/2008
Last updated
11/16/2011
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