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NPI Code Detail

MEDICARE: MS. MARY L CAVALIER FNP

MEDICARE: MS. MARY L CAVALIER FNP
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
1363LF0000XFamily Nurse PractitionerNP 0159CA

General Provider Information

NPI Number : 1255485744
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY L CAVALIER FNP
Provider Business Mailing Address
First Line : 21032 STRATHMOOR LN
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92646-7334
Country : US
Telephone Number : 714-968-6378
Fax Number :
Provider Business Practice Location Address
First Line : 8041 NEWMAN AVE
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92647-7034
Country : US
Telephone Number : 714-842-2829
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2007
Last Update Date : 07/08/2007

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