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Individual
MARTHA PLACK
Active
Individual
MARTHA PLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95212247
CA
363L00000X
Nurse Practitioner
Primary
95212247
CA
Other
Enumeration date
07/03/2024
Last updated
09/18/2024
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