Provider Demographics
NPI:1598429870
Name:KREITER, MARINA (APRN)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:KREITER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:455 TOLL GATE RD
Mailing Address - Street 2:PRC AND CREDENTIALING
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-5634
Mailing Address - Country:US
Mailing Address - Phone:401-273-0641
Mailing Address - Fax:401-273-2919
Practice Address - Street 1:70 KENYON AVE SUITE 210
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879
Practice Address - Country:US
Practice Address - Phone:401-788-8780
Practice Address - Fax:401-889-5082
Is Sole Proprietor?:No
Enumeration Date:2021-10-24
Last Update Date:2025-07-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT011717363LA2200X
RIAPRN03365363LG0600X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health