Provider Demographics
NPI:1184979965
Name:MARCIN, MAGGIE KRISTINE (CNP)
Entity type:Individual
Prefix:MRS
First Name:MAGGIE
Middle Name:KRISTINE
Last Name:MARCIN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MS
Other - First Name:MAGGIE
Other - Middle Name:KRISTINE
Other - Last Name:PANIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:3800 EMBASSY PKWY STE 240
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-8398
Mailing Address - Country:US
Mailing Address - Phone:330-665-4430
Mailing Address - Fax:
Practice Address - Street 1:3800 EMBASSY PKWY STE 240
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-8398
Practice Address - Country:US
Practice Address - Phone:216-286-6373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.13501363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty