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1124658067
MARIANNA GRACE BETTINA PUCILLO
TRUCKEE, CA
NPI
1124658067
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: CA 95013728)
Enumeration Date
2020-01-20
Last Update Date
2020-01-20
Business Address
MARIANNA GRACE BETTINA PUCILLO NP
10121 PINE AVE
TRUCKEE, CA 96161-4835
Phone number: 530-550-7206
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Mailing Address
MARIANNA GRACE BETTINA PUCILLO NP
PO BOX 77
TAHOE CITY, CA 96145-0077
Phone number: 781-454-9342
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