Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 95007549 | CA |
NPI | 1013411016 |
---|---|
Provider Name | Ms. Virginia Zebley |
First Address | Oceanside, CA 92056-2310 |
Second Address | San Diego, CA 92134-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2018 |
Last Update Date | 23/03/2018 |