Provider Demographics
NPI:1881311975
Name:MARINO, OLIVIA EDEN (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:EDEN
Last Name:MARINO
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 PARK EAST DRIVE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-508-4055
Mailing Address - Fax:
Practice Address - Street 1:3700 PARK EAST DRIVE
Practice Address - Street 2:SUITE 160
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-508-4055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0032346363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily