Provider Demographics
NPI:1487378303
Name:ADAMS, MARINA THERESA (FNP)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:THERESA
Last Name:ADAMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MARINA
Other - Middle Name:THERESA
Other - Last Name:BEACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:297 SPINDRIFT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7894
Mailing Address - Country:US
Mailing Address - Phone:716-831-2600
Mailing Address - Fax:716-831-2601
Practice Address - Street 1:297 SPINDRIFT DR STE 100
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7894
Practice Address - Country:US
Practice Address - Phone:716-831-2600
Practice Address - Fax:716-831-2601
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY753688-01163W00000X
NYF349719-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse