MEDICARE: MARIANE GILBERT 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
1	363L00000X	Nurse Practitioner	5558	CA

General Provider Information

NPI Number	:	1285616458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIANE GILBERT FNP

Provider Business Mailing Address
First Line	:	2350 BUHNE ST
Second Line	:	SUITE A
City	:	EUREKA
State	:	CA
Zip	:	95501-3238
Country	:	US
Telephone Number	:	707-443-4593
Fax Number	:

Provider Business Practice Location Address
First Line	:	2350 BUHNE ST
Second Line	:	SUITE A
City	:	EUREKA
State	:	CA
Zip	:	95501-3238
Country	:	US
Telephone Number	:	707-443-4593
Fax Number	:	707-443-7752

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

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	08/12/2013

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