Provider Demographics
NPI:1679240238
Name:VASSEUR, MARNI
Entity Type:Individual
Prefix:
First Name:MARNI
Middle Name:
Last Name:VASSEUR
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 1:131 E DAVIE ST APT 102
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27601-3037
Mailing Address - Country:US
Mailing Address - Phone:808-631-2058
Mailing Address - Fax:
Practice Address - Street 1:131 E DAVIE ST APT 102
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27601-3037
Practice Address - Country:US
Practice Address - Phone:808-631-2058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist