Provider Demographics
NPI:1457120453
Name:MARINO, KATHERINE J (FNP-C)
Entity type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:J
Last Name:MARINO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HOLBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-1085
Mailing Address - Country:US
Mailing Address - Phone:732-546-7416
Mailing Address - Fax:
Practice Address - Street 1:7 HOLBROOKE DR
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-1085
Practice Address - Country:US
Practice Address - Phone:732-546-7416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14972800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily