Provider Demographics
NPI:1811566128
Name:DIDYK, MARINA (MSN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MARINA
Middle Name:
Last Name:DIDYK
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:MARINA
Other - Middle Name:
Other - Last Name:SAVOCHKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:106 DARROW CREEK DR
Mailing Address - Street 2:
Mailing Address - City:OWENS CROSS ROADS
Mailing Address - State:AL
Mailing Address - Zip Code:35763-5001
Mailing Address - Country:US
Mailing Address - Phone:360-521-4277
Mailing Address - Fax:
Practice Address - Street 1:9238 MADISON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9112
Practice Address - Country:US
Practice Address - Phone:440-520-5919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-148936163W00000X, 363LF0000X
ALF03211123363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily