Provider Demographics
NPI:1629670872
Name:MARIONI, VICTORIA MICHELLE (RN)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MICHELLE
Last Name:MARIONI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6736 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CANUTILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79835-5415
Mailing Address - Country:US
Mailing Address - Phone:915-227-8017
Mailing Address - Fax:
Practice Address - Street 1:6736 1ST ST
Practice Address - Street 2:
Practice Address - City:CANUTILLO
Practice Address - State:TX
Practice Address - Zip Code:79835-5415
Practice Address - Country:US
Practice Address - Phone:915-227-8017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1007174163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse