Provider Demographics
NPI:1467207654
Name:MARCARELLI, TAMARA LYNN
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:LYNN
Last Name:MARCARELLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 RED ARROW WAY
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-1066
Mailing Address - Country:US
Mailing Address - Phone:615-617-0071
Mailing Address - Fax:
Practice Address - Street 1:363 RED ARROW WAY
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-1066
Practice Address - Country:US
Practice Address - Phone:615-617-0071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker