Provider Demographics
NPI:1437737566
Name:LUPISAN, MARIA ANGELICA MARASIGAN (APRN, NP-C)
Entity Type:Individual
Prefix:
First Name:MARIA ANGELICA
Middle Name:MARASIGAN
Last Name:LUPISAN
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:9124 LORDS LAKE CIR NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-9567
Mailing Address - Country:US
Mailing Address - Phone:540-532-3845
Mailing Address - Fax:
Practice Address - Street 1:4590 DRESSLER RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2546
Practice Address - Country:US
Practice Address - Phone:330-484-1607
Practice Address - Fax:330-484-2943
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.443547163W00000X
OHAPRN.CNP.0028617363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse