Individual
MARIE A MAGNUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
10140 DEER RUN FARMS RD, FORT MYERS, FL 33966-1045
(239) 275-3222
(239) 278-9058
Mailing address
2789 ORTIZ AVE, FORT MYERS, FL 33905-7806
(239) 275-3222
(239) 278-9058
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN1030962
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN1030962
RN LICENSE
FL
Enumeration date
08/02/2012
Last updated
08/02/2012
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