Provider Demographics
NPI:1992220115
Name:MARASCO, JOYCE PETRUZZI (CRNP)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:PETRUZZI
Last Name:MARASCO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:A
Other - Last Name:MARASCO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:565 COAL VALLEY RD FL 2
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3703
Mailing Address - Country:US
Mailing Address - Phone:412-578-7457
Mailing Address - Fax:412-578-3014
Practice Address - Street 1:565 COAL VALLEY RD FL 2
Practice Address - Street 2:
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3703
Practice Address - Country:US
Practice Address - Phone:412-578-7457
Practice Address - Fax:412-578-3014
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017738363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPENDINGMedicaid
PA14266654OtherCAQH