Basic Information
| Provider Information | |||||||||
| NPI: | 1891744330 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BISKER | ||||||||
| FirstName: | MARLENE | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 647 NORTH BROAD STREET EXT. | ||||||||
| Address2: | WOLF CREEK MEDICAL ASSOCIATES | ||||||||
| City: | GROVE CITY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 161274604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307599350 | ||||||||
| FaxNumber: | 3307599387 | ||||||||
| Practice Location | |||||||||
| Address1: | 631 NORTH BROAD STREET EXT. | ||||||||
| Address2: | |||||||||
| City: | GROVE CITY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 161274603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308414456 | ||||||||
| FaxNumber: | 3308414455 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2006 | ||||||||
| LastUpdateDate: | 05/21/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | RN267619 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 2002175 | 05 | OH | MEDICAID |