Provider Demographics
NPI:1578967162
Name:MARINO, TINA M (NP)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:M
Last Name:MARINO
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:3805 E BELL RD STE 3100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2136
Mailing Address - Country:US
Mailing Address - Phone:602-867-8644
Mailing Address - Fax:602-606-5128
Practice Address - Street 1:9100 N 2ND ST STE 321
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2459
Practice Address - Country:US
Practice Address - Phone:602-867-8644
Practice Address - Fax:602-606-5128
Is Sole Proprietor?:No
Enumeration Date:2014-10-10
Last Update Date:2023-04-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZTAP7371363LA2100X
AZAP7371363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care