Provider Demographics
NPI:1023059086
Name:SALDARIS, MARINA (CRNA)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:SALDARIS
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 1:1508 TWELVE OAKS DR
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2626
Mailing Address - Country:US
Mailing Address - Phone:219-465-8140
Mailing Address - Fax:
Practice Address - Street 1:1508 TWELVE OAKS DR
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2626
Practice Address - Country:US
Practice Address - Phone:219-465-8140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28155840A367500000X
FLARNP 9225795367500000X
IL367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered