Provider Demographics
NPI:1841083110
Name:MARINO, CAMILLA CRISTINA (RN)
Entity type:Individual
Prefix:
First Name:CAMILLA
Middle Name:CRISTINA
Last Name:MARINO
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 1:10900 WITTENRIDGE DR LOT K7
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-3498
Mailing Address - Country:US
Mailing Address - Phone:470-269-9180
Mailing Address - Fax:
Practice Address - Street 1:10475 MEDLOCK BRIDGE RD STE 820
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-4437
Practice Address - Country:US
Practice Address - Phone:678-224-8686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN211852207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology