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Individual
MS. MARY MARGARET FEDEWA
Active
Individual
MS. MARY MARGARET FEDEWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP CNS
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
15347
CA
363L00000X
Nurse Practitioner
Primary
4704149241
MI
364S00000X
Clinical Nurse Specialist
2258
CA
Other
Enumeration date
10/20/2012
Last updated
10/20/2012
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