| NPI | 1831504364 |
|---|---|
| Former Name | MARJORIE DESTEFANO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71004948A) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71004948A) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71004948A) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024185727) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71004948A) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2024-02-21 |