Provider Demographics
NPI:1548720634
Name:KOBRYN, MARINA (RN, WHNP-BC)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:KOBRYN
Suffix:
Gender:F
Credentials:RN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16857 SAN FERNANDO MISSION BLVD UNIT 56
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-4253
Mailing Address - Country:US
Mailing Address - Phone:818-625-3264
Mailing Address - Fax:
Practice Address - Street 1:16857 SAN FERNANDO MISSION BLVD UNIT 56
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-4253
Practice Address - Country:US
Practice Address - Phone:818-625-3264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-23
Last Update Date:2019-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA476190163WM0705X
CA10627363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical