Provider Demographics
NPI:1073752457
Name:MARRA, LORRIE M (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:LORRIE
Middle Name:M
Last Name:MARRA
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 254
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43086-0254
Mailing Address - Country:US
Mailing Address - Phone:614-865-3380
Mailing Address - Fax:
Practice Address - Street 1:315 MAINSAIL DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2742
Practice Address - Country:US
Practice Address - Phone:614-865-3380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN293977163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse