Provider Demographics
NPI:1376900688
Name:MARRERO, VIRMARIE (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:VIRMARIE
Middle Name:
Last Name:MARRERO
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1746 UPPER FORDE LN
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-2645
Mailing Address - Country:US
Mailing Address - Phone:240-210-6237
Mailing Address - Fax:301-990-0471
Practice Address - Street 1:2401 RESEARCH BLVD STE 370
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3269
Practice Address - Country:US
Practice Address - Phone:301-355-3280
Practice Address - Fax:301-990-0471
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR186373163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant