Individual
TARA MARCHIDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3050 REGENT BLVD, SUITE100, IRVING, TX 75063-3196
(214) 689-3600
(214) 689-3644
Mailing address
7474 ELM GROVE AVE, EASTVALE, CA 92880-9066
(951) 279-9175
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
14202
CA
363LG0600X
Gerontology Nurse Practitioner
14202
CA
Other
Enumeration date
10/10/2012
Last updated
10/10/2012
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