Provider Demographics
NPI:1194982090
Name:MARINO, RACHEL MEREDITH (CRNP)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:MEREDITH
Last Name:MARINO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:MEREDITH
Other - Last Name:BERGMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:8142 HAROLD CT
Mailing Address - Street 2:APT 1C
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4960
Mailing Address - Country:US
Mailing Address - Phone:410-631-6430
Mailing Address - Fax:
Practice Address - Street 1:NELSON 734 JOHNS HOPKINS HOSPITAL
Practice Address - Street 2:600 N. WOLFE STREET
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0001
Practice Address - Country:US
Practice Address - Phone:410-502-1856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR161372363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care