Provider Demographics
NPI:1851286736
Name:AVILA MORSTEDT, MARILYN SOLEDAD
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:SOLEDAD
Last Name:AVILA MORSTEDT
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 1:3404 GREEN HILL RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-2124
Mailing Address - Country:US
Mailing Address - Phone:717-980-1587
Mailing Address - Fax:
Practice Address - Street 1:3404 GREEN HILL RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-2124
Practice Address - Country:US
Practice Address - Phone:717-980-1587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty