Provider Demographics
NPI:1194325126
Name:MARRERO-MARRERO, AMY CORALY (DIRECT CARE WORKER -)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:CORALY
Last Name:MARRERO-MARRERO
Suffix:
Gender:F
Credentials:DIRECT CARE WORKER -
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 SPRING AVE
Mailing Address - Street 2:
Mailing Address - City:MOOREFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:26836-1036
Mailing Address - Country:US
Mailing Address - Phone:304-530-2256
Mailing Address - Fax:
Practice Address - Street 1:409 SPRING AVE
Practice Address - Street 2:
Practice Address - City:MOOREFIELD
Practice Address - State:WV
Practice Address - Zip Code:26836-1036
Practice Address - Country:US
Practice Address - Phone:304-530-2256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker