Doctor Name: | MS. MARY SUE ZIADY |
NPI Number: | 1356421358 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 216146 |
Business Practice Address: | 24473 Rose Ter Willits, CA - 954909449 |
Business Phone Number: | 7074597075 |
Business Fax Number: | |
Mailing Address: | 24473 Rose Ter, WILLITS |
State: | CA |
Postal Code: | 954909449 |
Phone Number: | 7074597075 |
Fax Number: | |
NPI Enumeration Date: | 10/16/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LW0102X |
License Number: | 216146 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Women's Health |
Taxonomy Definition: |