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NPI Code Detail

MEDICARE: MRS. MARY THERESA BILBRO FNP

MEDICARE: MRS. MARY THERESA BILBRO FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse602555CA
2363LF0000XFamily Nurse PractitionerNP95001838CA

General Provider Information

NPI Number : 1295010866
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY THERESA BILBRO FNP
Provider Business Mailing Address
First Line : 484 WASHINGTON ST # B141
Second Line :
City : MONTEREY
State : CA
Zip : 93940-3050
Country : US
Telephone Number : 831-331-6745
Fax Number :
Provider Business Practice Location Address
First Line : 10 HARRIS CT BLDG A
Second Line : STE A1
City : MONTEREY
State : CA
Zip : 93940-5704
Country : US
Telephone Number : 831-643-9788
Fax Number : 831-657-0161
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2011
Last Update Date : 01/06/2015

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