Provider Demographics
NPI:1073803433
Name:MARRO, DANIEL A (LPN)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:A
Last Name:MARRO
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 W QUINALT ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-2756
Mailing Address - Country:US
Mailing Address - Phone:509-475-4456
Mailing Address - Fax:
Practice Address - Street 1:755 W QUINALT ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-2756
Practice Address - Country:US
Practice Address - Phone:509-475-4456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXB1769539146N00000X
OR200830407LPN164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic