MEDICARE: FEMA MARIE PANERIO ARDIENTE RN

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	163W00000X	Registered Nurse	95164318	CA

General Provider Information

NPI Number	:	1548017692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FEMA MARIE PANERIO ARDIENTE RN

Provider Business Mailing Address
First Line	:	5721 W LAS POSITAS BLVD APT 419
Second Line	:
City	:	PLEASANTON
State	:	CA
Zip	:	94588-4261
Country	:	US
Telephone Number	:	510-480-7466
Fax Number	:

Provider Business Practice Location Address
First Line	:	5721 W LAS POSITAS BLVD APT 419
Second Line	:
City	:	PLEASANTON
State	:	CA
Zip	:	94588-4261
Country	:	US
Telephone Number	:	510-480-7466
Fax Number	:

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

Provider Enumeration Date	:	05/06/2024
Last Update Date	:	05/06/2024

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