Forrest, Marissa P

Forrest, Marissa P is an sole proprietor health care provider with primary practice located at 140 Colemans Crossing Boulevard Suite 210, Marysville OH 43040-0000. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Forrest, Marissa P can be contacted via phone (937) 644-1441.

Contact Information

Primary practice address
140 Colemans Crossing Boulevard Suite 210 Marysville OH 43040-0000
Phone: (937) 644-1441
Fax: (937) 642-7760
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN.CNP.00108 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X APRN.CNP.00108 Ohio

Profile Details

NPI number 1386692986
LBN Legal business name Forrest, Marissa P
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 5th, 2006
Last updated Mar 22nd, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386692986 NPPES
Ohio MEDICAID 2023714

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