Provider Demographics
NPI:1639577604
Name:MARINO, SONJA NICOLE (FNP-C)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:NICOLE
Last Name:MARINO
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:ONE HEALTHY PLACE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062
Mailing Address - Country:US
Mailing Address - Phone:220-564-1925
Mailing Address - Fax:220-564-1926
Practice Address - Street 1:ONE HEALTHY PLACE
Practice Address - Street 2:SUITE 203
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062
Practice Address - Country:US
Practice Address - Phone:220-564-1925
Practice Address - Fax:220-564-1926
Is Sole Proprietor?:No
Enumeration Date:2014-12-08
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.16522363LF0000X, 363LP0200X
OH16522-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily