Provider Demographics
NPI:1144745209
Name:MARINO, LAUREE J (RN)
Entity type:Individual
Prefix:
First Name:LAUREE
Middle Name:J
Last Name:MARINO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15802 N PARKVIEW PL
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-7466
Mailing Address - Country:US
Mailing Address - Phone:623-523-8504
Mailing Address - Fax:623-523-8511
Practice Address - Street 1:15272 W GABRIELA DR
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-6324
Practice Address - Country:US
Practice Address - Phone:623-523-8504
Practice Address - Fax:623-523-8511
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ162921163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool