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NPI Code Detail

MEDICARE: MS. CAROL A MARIETTA N.P.

MEDICARE:  MS. CAROL A MARIETTA  N.P.
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 Practitioner13856CA

General Provider Information

NPI Number : 1427053206
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CAROL A MARIETTA N.P.
Provider Business Mailing Address
First Line : 39000 BOB HOPE DR
Second Line :
City : RANCHO MIRAGE
State : CA
Zip : 92270-3221
Country : US
Telephone Number : 760-837-8470
Fax Number :
Provider Business Practice Location Address
First Line : 39000 BOB HOPE DR
Second Line :
City : RANCHO MIRAGE
State : CA
Zip : 92270-3221
Country : US
Telephone Number : 760-837-8470
Fax Number : 760-773-1467
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 01/26/2021

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Directions to “ MS. CAROL A MARIETTA N.P.” Practice Location

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