Doctor Name: | MARIE GUSTAFSON |
NPI Number: | 1386789485 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | RN563205 |
Business Practice Address: | 8382 Easton Rd Ottsville, PA - 189429688 |
Business Phone Number: | 6108475708 |
Business Fax Number: | |
Mailing Address: | 8382 Easton Rd, OTTSVILLE |
State: | PA |
Postal Code: | 189429688 |
Phone Number: | 6108475708 |
Fax Number: | |
NPI Enumeration Date: | 02/20/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WM1400X |
License Number: | RN563205 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Nurse Massage Therapist (NMT) |
Taxonomy Definition: |