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General NPI Number Information
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NPI Number | 1861727653
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Entity Type | Individual
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Provider Name | MARIANNE GREGORICH FNP
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Gender | Female
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Dates
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Enumeration Date | 10/12/2009
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 74785 US HIGHWAY 111 STE 101
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City | INDIAN WELLS
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State | CA
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Zip | 92210-7129
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Country | US
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Telephone | 760-322-8883
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Fax |
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Provider Business Mailing Address
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Address Line | 74785 US HIGHWAY 111 STE 101
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City | INDIAN WELLS
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State | CA
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Zip | 92210-7129
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Country | US
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Telephone | 608-279-6626
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Fax | 310-582-7996
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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 | 95007760
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License Number State | CA
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