Provider Demographics
NPI:1659888683
Name:MAREMA, WHITNEY MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:MARIE
Last Name:MAREMA
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 1:300 HEALTH PARK BLVD STE 5002
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-3705
Mailing Address - Country:US
Mailing Address - Phone:904-501-6203
Mailing Address - Fax:
Practice Address - Street 1:300 HEALTH PARK BLVD STE 5002
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-3705
Practice Address - Country:US
Practice Address - Phone:904-501-6203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-28
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3417842163WM0705X, 363LP2300X
FLAPRN3417842363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care