Provider Demographics
NPI:1598504524
Name:MARRACCINI, MAKAYLA NICOLE I (NA)
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:NICOLE
Last Name:MARRACCINI
Suffix:I
Gender:F
Credentials:NA
Other - Prefix:MS
Other - First Name:MARRACCINI
Other - Middle Name:NICOLE
Other - Last Name:MARRACCINI
Other - Suffix:I
Other - Last Name Type:Former Name
Other - Credentials:NA
Mailing Address - Street 1:1018 35TH ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-2607
Mailing Address - Country:US
Mailing Address - Phone:330-327-2213
Mailing Address - Fax:330-327-2213
Practice Address - Street 1:1018 35TH ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-2607
Practice Address - Country:US
Practice Address - Phone:330-327-2213
Practice Address - Fax:330-327-2213
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHVA080067376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker