Provider Demographics
NPI:1194202663
Name:GERMINAL, MARIE C (ARNP)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:C
Last Name:GERMINAL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 S 21ST ST STE B
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4829
Mailing Address - Country:US
Mailing Address - Phone:772-252-4872
Mailing Address - Fax:772-252-4873
Practice Address - Street 1:850 S 21ST ST STE B
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4829
Practice Address - Country:US
Practice Address - Phone:772-252-4872
Practice Address - Fax:772-252-4873
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9284522363LP2300X
FLAPRN9284522363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care