Provider Demographics
NPI:1558703090
Name:YACINTHE, MARYNA RUDENKO (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MARYNA
Middle Name:RUDENKO
Last Name:YACINTHE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:738 BRYANT ST
Mailing Address - Street 2:STE A
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-4189
Mailing Address - Country:US
Mailing Address - Phone:704-682-1875
Mailing Address - Fax:
Practice Address - Street 1:738 BRYANT ST STE A
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-4189
Practice Address - Country:US
Practice Address - Phone:704-873-1116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC223804363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily