Provider Demographics
NPI:1518939479
Name:JOLIN, MARIANNE DEBRUIJN (CNM)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:DEBRUIJN
Last Name:JOLIN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-337-4487
Mailing Address - Fax:717-461-7149
Practice Address - Street 1:450 S WASHINGTON ST STE B
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2500
Practice Address - Country:US
Practice Address - Phone:717-337-4487
Practice Address - Fax:717-461-7149
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW008433L367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30108963OtherAMERIHEALTH MERCY-WMG
PA417697OtherUPMC
PA30111723OtherAMERIHEALTH MERCY-WMG ACWH
PA269244OtherHIGHMARK BLUE SHIELD
PA5155716OtherAETNA PPO PROVIDER NUMBER
PA1603980OtherGATEWAY MEDICARE ASSURED
PA3432450OtherAETNA HMO PROVIDER NUMBER
PA50026638OtherCAPITAL BLUE CROSS
PA30111723OtherAMERIHEALTH MERCY-WMG ACWH
PA3432450OtherAETNA HMO PROVIDER NUMBER