Healthcare Provider Details

I. General information

NPI: 1699789503
Provider Name (Legal Business Name): MARJAN VIZCAINO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 SKY COURT
KELOWNA BRITISH COLUMBIA
V1V 3A2
CA

IV. Provider business mailing address

132 SKY COURT
KELOWNA BRITISH COLUMBIA
V1V 3A2
CA

V. Phone/Fax

Practice location:
  • Phone: 250-808-1377
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP30007374
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: