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General NPI Number Information
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NPI Number | 1285085456
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Entity Type | Individual
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Provider Name | HEATHER MARIE MAGGIO FNP
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Gender | Female
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Dates
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Enumeration Date | 06/28/2016
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Last Update Date | 06/23/2021
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Provider Practice Location Address
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Address Line | 1444 FLORIDA AVE STE 202
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City | MODESTO
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State | CA
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Zip | 95350-4400
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Country | US
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Telephone | 209-524-1264
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Fax | 209-524-8218
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Provider Business Mailing Address
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Address Line | 737 W CHILDS AVE
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City | MERCED
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State | CA
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Zip | 95341-6805
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Country | US
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Telephone |
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP95004673
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN683793
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License Number State | CA
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