Provider Demographics
NPI:1487737201
Name:MARINI, PAMELA ANNE (MSRN FNP NPP)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:ANNE
Last Name:MARINI
Suffix:
Gender:F
Credentials:MSRN FNP NPP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:30 KETCHUM ST
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-1355
Mailing Address - Country:US
Mailing Address - Phone:585-394-0530
Mailing Address - Fax:585-349-3872
Practice Address - Street 1:35 NORTH STREET
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424
Practice Address - Country:US
Practice Address - Phone:585-349-0530
Practice Address - Fax:585-394-3872
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333244363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health