Provider Demographics
NPI:1699239442
Name:MARUNOWSKI, NAKIA (RN)
Entity type:Individual
Prefix:
First Name:NAKIA
Middle Name:
Last Name:MARUNOWSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3042 PORTER RD
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:OH
Mailing Address - Zip Code:44201-9539
Mailing Address - Country:US
Mailing Address - Phone:440-289-0211
Mailing Address - Fax:
Practice Address - Street 1:118 W STREETSBORO ST STE 139
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-2752
Practice Address - Country:US
Practice Address - Phone:330-597-9040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-25
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GURE2307163W00000X
PA641774163W00000X
FL9321636163W00000X
CA831304163W00000X
OH356778163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse