Provider Demographics
NPI:1033430947
Name:MACRI, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:MACRI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:MACRI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:19299 EDINBURGH DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46614-5865
Mailing Address - Country:US
Mailing Address - Phone:574-855-1913
Mailing Address - Fax:
Practice Address - Street 1:19299 EDINBURGH DR
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46614-5865
Practice Address - Country:US
Practice Address - Phone:574-855-1913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN163W0000X163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse