Provider Demographics
NPI:1285367854
Name:GERBITZ, MARISSA
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:GERBITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29111 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4005
Mailing Address - Country:US
Mailing Address - Phone:440-646-1600
Mailing Address - Fax:440-646-1505
Practice Address - Street 1:265 PORTAGE TRAIL EXT W STE 200
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-3613
Practice Address - Country:US
Practice Address - Phone:234-274-7546
Practice Address - Fax:330-680-6851
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0031015363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily