Provider Demographics
NPI:1578294559
Name:MARIANA, KERINA (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KERINA
Middle Name:
Last Name:MARIANA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9850 N NIOBRARA WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-8655
Mailing Address - Country:US
Mailing Address - Phone:520-668-9303
Mailing Address - Fax:
Practice Address - Street 1:4892 N STONE AVE STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-5761
Practice Address - Country:US
Practice Address - Phone:520-396-1360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ276715363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care