MRS. MARINA DEATHERAGE

Nurse Practitioner

Active Individual
NPI: 1538706858

Practice Address

146 E GENEVA SQ
Lake Geneva, WI 53147

Phone: (262) 249-4660

Specialties

Specialty Code Primary License
Nurse Practitioner - Family 363LF0000X No 209020317 (IL)
Nurse Practitioner 363L00000X Yes 10857-033 (WI)

Frequently Asked Questions

NPI 1538706858 is the National Provider Identifier for MRS. MARINA DEATHERAGE, a Nurse Practitioner provider located in Lake Geneva, WI. This NPI was enumerated on December 5, 2019.
MRS. MARINA DEATHERAGE practices at 146 E GENEVA SQ, Lake Geneva, WI 53147.

Quick Facts

NPI
1538706858
Type
Individual
Enumerated
Dec 5, 2019
Last Updated
Nov 30, 2021

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