Provider Demographics
NPI:1427560697
Name:SARTORI, MARIE NICOLE (APRN)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:NICOLE
Last Name:SARTORI
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 1:220 GREENUP ST APT 408
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-5730
Mailing Address - Country:US
Mailing Address - Phone:859-250-9473
Mailing Address - Fax:
Practice Address - Street 1:7766 EWING BLVD STE 100
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042
Practice Address - Country:US
Practice Address - Phone:859-283-1033
Practice Address - Fax:859-283-1066
Is Sole Proprietor?:No
Enumeration Date:2017-10-27
Last Update Date:2019-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013235363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH390200000XOtherRN
31-6000064OtherCHD