Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 14809 | CA |
NPI | 1003139908 |
---|---|
Provider Name | Linda Helen Marshall |
First Address | Santee, CA 92071-2808 |
Second Address | Chula Vista, CA 91911-6617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2010 |
Last Update Date | 05/03/2010 |