Provider Demographics
NPI:1326673450
Name:CAWTHRA, MARINA (APRN)
Entity Type:Individual
Prefix:MISS
First Name:MARINA
Middle Name:
Last Name:CAWTHRA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4128 MONROE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-7708
Mailing Address - Country:US
Mailing Address - Phone:704-337-0133
Mailing Address - Fax:
Practice Address - Street 1:8535 CLIFF CAMERON DR STE 116
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-5909
Practice Address - Country:US
Practice Address - Phone:704-971-9191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-09
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11006390363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
1568780591OtherDR.ARIN PIRAMZADIAN DO
NC1790282853OtherSTARMED URGENT AND FAMILY CARE