Individual
MARY L. MAXIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N., C.D.E.
Contact information
Practice address
2720 LOW CT, FAIRFIELD, CA 94534-9771
(707) 428-2731
(707) 428-2740
Mailing address
2720 LOW CT, FAIRFIELD, CA 94534-9771
(707) 428-2731
(707) 428-2740
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
523078
CA
Other
Enumeration date
01/14/2009
Last updated
01/14/2009
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