| Doctor Name: | MARIENA LOUISE NUNNERY |
| NPI Number: | 1093830481 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 599 Tomales Clinic Petaluma, CA - 949525000 |
| Business Phone Number: | 7077657200 |
| Business Fax Number: | |
| Mailing Address: | 4145 Shadow Ln, Apt.#527 SANTA ROSA |
| State: | CA |
| Postal Code: | 954055265 |
| Phone Number: | 9153454077 |
| Fax Number: | |
| NPI Enumeration Date: | 03/21/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246QM0706X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Spec/Tech, Pathology |
| Taxonomy Specialization: | Medical Technologist |
| Taxonomy Definition: | |