Provider Demographics
NPI:1417757089
Name:MARINO, ROSEANN MARIE (RN)
Entity type:Individual
Prefix:
First Name:ROSEANN
Middle Name:MARIE
Last Name:MARINO
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 DRAKE VIEW CT
Mailing Address - Street 2:
Mailing Address - City:NORTH LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:44452-8572
Mailing Address - Country:US
Mailing Address - Phone:330-727-3625
Mailing Address - Fax:
Practice Address - Street 1:1100 DRAKE VIEW CT
Practice Address - Street 2:
Practice Address - City:NORTH LIMA
Practice Address - State:OH
Practice Address - Zip Code:44452-8572
Practice Address - Country:US
Practice Address - Phone:330-727-3625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN233531163W00000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No163W00000XNursing Service ProvidersRegistered Nurse