Provider Demographics
NPI:1336718014
Name:MARINE, ALIYE CLAIRE (APRN)
Entity Type:Individual
Prefix:
First Name:ALIYE
Middle Name:CLAIRE
Last Name:MARINE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ALIYE
Other - Middle Name:CLAIRE
Other - Last Name:MARINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:65 GERMANTOWN CT STE 300
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4258
Mailing Address - Country:US
Mailing Address - Phone:901-737-4665
Mailing Address - Fax:901-328-1355
Practice Address - Street 1:9500 MENTOR AVE STE 340
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-8702
Practice Address - Country:US
Practice Address - Phone:440-352-9400
Practice Address - Fax:440-352-9407
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-17
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9470113163W00000X
FL11013761363LF0000X
OHRN.4418223363LF0000X
OHAPRN.CNP.0032264363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse