Provider Demographics
NPI:1689983348
Name:MARAZON, STEPHANIE M (RN, CNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:MARAZON
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1729 27TH ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-2638
Mailing Address - Country:US
Mailing Address - Phone:740-354-1434
Mailing Address - Fax:740-353-8811
Practice Address - Street 1:1729 27TH ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-2638
Practice Address - Country:US
Practice Address - Phone:740-354-1434
Practice Address - Fax:740-353-8811
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA11708-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily