Provider Demographics
NPI:1477338655
Name:MALONE, MARIN NOLAN (RN, BSN, MSN,CPNP-PC)
Entity Type:Individual
Prefix:MS
First Name:MARIN
Middle Name:NOLAN
Last Name:MALONE
Suffix:
Gender:F
Credentials:RN, BSN, MSN,CPNP-PC
Other - Prefix:
Other - First Name:MARIN
Other - Middle Name:ALANA DEPALMA
Other - Last Name:NOLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:325 N MANCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1118
Mailing Address - Country:US
Mailing Address - Phone:703-314-2034
Mailing Address - Fax:
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2916
Practice Address - Country:US
Practice Address - Phone:202-476-6883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
DCNP1043785363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program