Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Marissa Marie Sudomoin, NP

Individual provider Primary Care Nurse Practitioner · NPI 1518624360

Marissa Marie Sudomoin, NP is a Nurse Practitioner in Paoli, Pennsylvania. Qualified in 2020, 6 years ago. Practices with Main Line Healthcare, a 1,153-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Pennsylvania.

Years since qualifying
6
Licensed in
PA
In the registry since
2021
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

See every abbreviation used in this directory →

Practice location Address checks out

255 W Lancaster Ave
Paoli, PA 19301-1763
Phone: (484) 565-1601
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence SP023134 (PA)

Record details

NPI number1518624360
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedNovember 29, 2021
Last updated in NPPESNovember 29, 2021
Certification dateNovember 29, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Main Line Healthcare — 1153 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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