Provider Demographics
NPI:1790423150
Name:CHIMINO, MARCIA LYNN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:LYNN
Last Name:CHIMINO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6195 MARCELLA BLVD
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-0040
Mailing Address - Country:US
Mailing Address - Phone:219-942-7100
Mailing Address - Fax:
Practice Address - Street 1:6195 MARCELLA BLVD
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-0040
Practice Address - Country:US
Practice Address - Phone:219-942-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71012602A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner