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NPI Code Detail

MEDICARE: KRISTINE C MAKI N.P.

MEDICARE:   KRISTINE C MAKI  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
1163W00000XRegistered Nurse603819CA
2363L00000XNurse Practitioner13619CA

General Provider Information

NPI Number : 1609959576
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINE C MAKI N.P.
Provider Business Mailing Address
First Line : PO BOX 779
Second Line :
City : STOCKTON
State : CA
Zip : 95201-0779
Country : US
Telephone Number : 209-373-2800
Fax Number : 209-373-2873
Provider Business Practice Location Address
First Line : 701 E CHANNEL ST
Second Line :
City : STOCKTON
State : CA
Zip : 95202-2628
Country : US
Telephone Number : 209-944-4700
Fax Number : 209-944-4795
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2006
Last Update Date : 03/11/2010

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Directions to “ KRISTINE C MAKI N.P.” Practice Location

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