Provider Demographics
NPI:1306504725
Name:TRUBINA, MARIYA (DNP, CRNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:MARIYA
Middle Name:
Last Name:TRUBINA
Suffix:
Gender:F
Credentials:DNP, CRNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8580 VERREE RD
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-1370
Mailing Address - Country:US
Mailing Address - Phone:215-214-3815
Mailing Address - Fax:215-214-3816
Practice Address - Street 1:8580 VERREE RD
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-1370
Practice Address - Country:US
Practice Address - Phone:215-214-3815
Practice Address - Fax:215-214-3816
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP024555363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily