Provider Demographics
NPI:1225048630
Name:MCCOOL, MARIANNE E (ARNP)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:E
Last Name:MCCOOL
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 1:2595 INTERSTATE DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-9378
Mailing Address - Country:US
Mailing Address - Phone:386-672-4222
Mailing Address - Fax:386-672-8855
Practice Address - Street 1:2595 INTERSTATE DR
Practice Address - Street 2:SUITE 103
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-9378
Practice Address - Country:US
Practice Address - Phone:386-672-4222
Practice Address - Fax:386-672-8855
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3421552363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000872600Medicaid
FL000872600Medicaid