National Provider Identifier

Marissa Iddings, LPN

Marissa Iddings, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Geneva, NY and a listed phone number of (315) 651-7527.

NPI 1245851948Geneva, NYLicensed Practical Nurse

Profile Overview

NPI
1245851948
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
May 04, 2020
Last Updated
May 04, 2020

Practice Location

  • 71 Sherrill St
  • Geneva, NY 14456-1156

Phone: (315) 651-7527

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1245851948
Entity Type
Individual
Last Name
Iddings
First Name
Marissa
Credential
LPN
Provider Other Last Name
Trunzo
Provider Other First Name
Marissa
Provider Other Last Name Type Code
5
Mailing Street Address
71 Sherrill St
Mailing City
Geneva
Mailing State
NY
Mailing ZIP Code
14456-1156
Mailing Country
US
Mailing Phone
(315) 651-7527
Practice Street Address
71 Sherrill St
Practice City
Geneva
Practice State
NY
Practice ZIP Code
14456-1156
Practice Country
US
Practice Phone
(315) 651-7527
Enumeration Date
May 04, 2020
Last Updated
May 04, 2020
Sex
Female
Sole Proprietor
Yes
Certification Date
May 04, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)