Provider Demographics
NPI:1740519552
Name:NEWTOFF, MARISSA K (MSN, ACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:K
Last Name:NEWTOFF
Suffix:
Gender:F
Credentials:MSN, ACNP-BC
Other - Prefix:MS
Other - First Name:MARISSA
Other - Middle Name:K
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, ACNP-BC
Mailing Address - Street 1:4400 W 95TH ST STE 308
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2660
Mailing Address - Country:US
Mailing Address - Phone:087-346-4040
Mailing Address - Fax:087-346-3287
Practice Address - Street 1:4400 W 95TH ST STE 308
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2660
Practice Address - Country:US
Practice Address - Phone:708-346-4040
Practice Address - Fax:708-346-3287
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.007871363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care