Provider Demographics
NPI:1629842745
Name:CRASI, MARISSA ROSE
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:ROSE
Last Name:CRASI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 VAN BUREN RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:OH
Mailing Address - Zip Code:44216-8820
Mailing Address - Country:US
Mailing Address - Phone:330-620-8024
Mailing Address - Fax:
Practice Address - Street 1:880 MULL AVE STE 203
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-7522
Practice Address - Country:US
Practice Address - Phone:234-208-6867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0032932363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily