Provider Demographics
NPI:1265779185
Name:MALINOWSKI, MARILYN DENISE (MSN, CRNP, CRNFA)
Entity type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:DENISE
Last Name:MALINOWSKI
Suffix:
Gender:F
Credentials:MSN, CRNP, CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 SPRING VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-4301
Mailing Address - Country:US
Mailing Address - Phone:215-322-7468
Mailing Address - Fax:
Practice Address - Street 1:3300 TILLMAN DR
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-2071
Practice Address - Country:US
Practice Address - Phone:215-244-7803
Practice Address - Fax:215-940-9454
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-11
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012663363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health