Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | NP18019 | CA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | NP18019 | CA |
NPI | 1013158567 |
---|---|
Provider Name | Ms. Marianne Placey |
First Address | San Diego, CA 92107-3711 |
Second Address | San Diego, CA 92111-5800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2009 |
Last Update Date | 12/03/2009 |