Individual provider Active NPI

Marianne Bove, CRNP

  • Pediatric Nurse Practitioner
  • Erie, PA
National Provider Identifier
1861861270
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
UP004989D Issued in PA
Practice address
3330 Peach St
Suite 106
Erie, PA 16508-2769
Phone
(814) 877-8586
Fax
(814) 877-8591
NPI assigned
Sep 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X UP004989D PA Primary

Addresses

Primary practice location

3330 Peach St
Suite 106
Erie, PA 16508-2769

Mailing address

11279 Perry Hwy
Suite 450
Wexford, PA 15090-9381
Phone (724) 933-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
UP004989DPAMDPediatric Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: mbove43340@upmc.direct-ci.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1861861270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11279 PERRY HWY",
            "address_2": "SUITE 450",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909381",
            "telephone_number": "724-933-1100",
            "fax_number": "724-933-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 PEACH ST",
            "address_2": "SUITE 106",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082769",
            "telephone_number": "814-877-8586",
            "fax_number": "814-877-8591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVE",
        "first_name": "MARIANNE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "UP004989D",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.