Provider Demographics
NPI:1073057329
Name:MARINOS, STEVEN ANGELOS (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:ANGELOS
Last Name:MARINOS
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 REGULATOR DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-8719
Mailing Address - Country:US
Mailing Address - Phone:919-437-7077
Mailing Address - Fax:
Practice Address - Street 1:107 REGULATOR DR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-8719
Practice Address - Country:US
Practice Address - Phone:919-437-7077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC131664363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology