MARIETTA FORMOSO LIGHT

CLOVIS, CA
NPI1750368650
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LX0001X Nurse Practitioner, Obstetrics & Gynecology
(Licence: CA  6030)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: CA  6030)
363LW0102X Nurse Practitioner, Women's Health
(Licence: CA  6030)
Enumeration Date2005-12-30
Last Update Date2020-10-08
Business Address
MARIETTA FORMOSO LIGHT NP-C
782 MEDICAL CENTER DR E STE 212
CLOVIS, CA 93611-6889
Phone number: 559-451-3676
Mailing Address
MARIETTA FORMOSO LIGHT NP-C
2625 E DIVISADERO ST
FRESNO, CA 93721-1431
Phone number: 559-443-2682