Provider Demographics
NPI:1891744330
Name:BISKER, MARLENE A (CRNA)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:A
Last Name:BISKER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:647 NORTH BROAD STREET EXT.
Mailing Address - Street 2:WOLF CREEK MEDICAL ASSOCIATES
Mailing Address - City:GROVE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16127-4604
Mailing Address - Country:US
Mailing Address - Phone:330-759-9350
Mailing Address - Fax:330-759-9387
Practice Address - Street 1:631 NORTH BROAD STREET EXT.
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-4603
Practice Address - Country:US
Practice Address - Phone:330-841-4456
Practice Address - Fax:330-841-4455
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN267619367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2002175Medicaid