Individual
AMY MARIE MACKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
450 BROADWAY ST, REDWOOD CITY, CA 94063
(640) 721-7332
Mailing address
1804 EMBARCADERO RD, STE 100, PALO ALTO, CA 94303-3341
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95079299
CA
363L00000X
Nurse Practitioner
Primary
95003900
CA
Other
Enumeration date
05/13/2016
Last updated
06/20/2016
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