Provider Demographics
NPI:1508672585
Name:HO, MARYANN (FNP-C)
Entity type:Individual
Prefix:
First Name:MARYANN
Middle Name:
Last Name:HO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1143 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-5132
Mailing Address - Country:US
Mailing Address - Phone:267-247-6544
Mailing Address - Fax:
Practice Address - Street 1:849 COOPER ST
Practice Address - Street 2:
Practice Address - City:DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-2571
Practice Address - Country:US
Practice Address - Phone:856-848-6346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15215700363LF0000X
PASP030606363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily