Provider Demographics
NPI:1124410626
Name:PILARSKI, MARISA (NP)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:PILARSKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 W MITCHELL ST
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2357
Mailing Address - Country:US
Mailing Address - Phone:586-531-0453
Mailing Address - Fax:
Practice Address - Street 1:116 W MITCHELL ST
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2357
Practice Address - Country:US
Practice Address - Phone:586-531-0453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-21
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704272699363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily