MEDICARE: MARILYN ORLOVA-ZITZER IV FNP, CRNFA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	NP13143	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NP0131431	OTHER	CA	BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114922465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARILYN ORLOVA-ZITZER IV FNP, CRNFA

Provider Business Mailing Address
First Line	:	PO BOX 612
Second Line	:
City	:	LARKSPUR
State	:	CA
Zip	:	94977-0612
Country	:	US
Telephone Number	:	415-453-3220
Fax Number	:	415-453-3220

Provider Business Practice Location Address
First Line	:	14 PRESIDIO CT
Second Line	:
City	:	CORTE MADERA
State	:	CA
Zip	:	94925-2066
Country	:	US
Telephone Number	:	415-453-3220
Fax Number	:	415-453-3220

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	07/30/2012

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