MEDICARE: MS. MARIA RECURT HIBDON 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	285715	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881630085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIA RECURT HIBDON FNP

Provider Business Mailing Address
First Line	:	406 SUNRISE AVE
Second Line	:	SUITE 280
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-4106
Country	:	US
Telephone Number	:	916-782-3786
Fax Number	:	916-773-6251

Provider Business Practice Location Address
First Line	:	406 SUNRISE AVE
Second Line	:	SUITE 280
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-4106
Country	:	US
Telephone Number	:	916-782-3786
Fax Number	:	916-773-6251

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	02/29/2012

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