Provider Demographics
NPI:1366227464
Name:TRZASKOMA, MARISSA LEE (APRN)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:LEE
Last Name:TRZASKOMA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-2901
Mailing Address - Country:US
Mailing Address - Phone:330-382-0165
Mailing Address - Fax:330-382-0275
Practice Address - Street 1:146 W 5TH ST
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-2901
Practice Address - Country:US
Practice Address - Phone:330-382-0165
Practice Address - Fax:330-382-0275
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2025-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028667363LF0000X
OHRN.512692163W00000X
PA629333163W00000X
OHAPRN.CNP.0034922363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse