| Doctor Name: | MARILYN CIESZYKOWSKI |
| NPI Number: | 1700875804 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 17661 |
| Business Practice Address: | 507 Central Ave Dolores, CO - 813230908 |
| Business Phone Number: | 9708827221 |
| Business Fax Number: | 9708824243 |
| Mailing Address: | Po Box 1251, DOLORES |
| State: | CO |
| Postal Code: | 813231251 |
| Phone Number: | 9708827221 |
| Fax Number: | 9708828483 |
| NPI Enumeration Date: | 10/20/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 17661 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |