Provider Demographics
NPI:1174058762
Name:ZURBANO, MARRIANE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:MARRIANE
Middle Name:
Last Name:ZURBANO
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4579 MAPLE AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-3154
Mailing Address - Country:US
Mailing Address - Phone:619-567-2258
Mailing Address - Fax:
Practice Address - Street 1:4579 MAPLE AVE STE 1
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-3154
Practice Address - Country:US
Practice Address - Phone:619-567-2258
Practice Address - Fax:888-628-6680
Is Sole Proprietor?:No
Enumeration Date:2017-04-20
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95006441363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner