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General NPI Number Information
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NPI Number | 1083802441
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Entity Type | Individual
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Provider Name | MARILYN JOSE F.N.P, ACNP
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Gender | Female
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 6720 BERTNER AVE
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City | HOUSTON
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State | TX
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Zip | 77030-2604
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Country | US
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Telephone | 823-355-2666
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Fax |
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Provider Business Mailing Address
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Address Line | 6565 FANNIN ST FONDREN 270
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City | HOUSTON
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State | TX
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Zip | 77030-2703
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Country | US
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Telephone | 713-441-0006
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Fax | 713-790-2727
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 613487
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License Number State | TX
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