Individual
MARIETTA GINGOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN RN MSN
Contact information
Practice address
15956 W CORTEZ ST, SURPRISE, AZ 85379-1162
(623) 440-6659
Mailing address
15956 W CORTEZ ST, SURPRISE, AZ 85379-1162
(623) 440-6659
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALM-011151
AZ
Other
Enumeration date
10/10/2022
Last updated
10/10/2022
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