Provider Demographics
NPI:1730793035
Name:MARANZANO, LENNY (RN)
Entity type:Individual
Prefix:MR
First Name:LENNY
Middle Name:
Last Name:MARANZANO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2355 THOMAS AVE APT 2302
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-5427
Mailing Address - Country:US
Mailing Address - Phone:623-296-8857
Mailing Address - Fax:
Practice Address - Street 1:4099 MCEWEN RD STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-5050
Practice Address - Country:US
Practice Address - Phone:623-296-8857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN163126163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse