Healthcare Provider Details

I. General information

NPI: 1740559301
Provider Name (Legal Business Name): MARJOREE NEER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2011
Last Update Date: 12/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 N TU SU LN
BISHOP CA
93514-8058
US

IV. Provider business mailing address

52 N TU SU LN
BISHOP CA
93514-8058
US

V. Phone/Fax

Practice location:
  • Phone: 760-872-2622
  • Fax: 760-873-6362
Mailing address:
  • Phone: 760-872-2622
  • Fax: 760-873-6362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number384001
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number384001
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: