Individual
MARY PUTNAM COUSINEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BC-PNP
Contact information
Practice address
10561 MERRITT ST, CASTROVILLE, CA 95012-3310
(831) 633-1514
Mailing address
12 LA MIRADA CT, SALINAS, CA 93901-3857
(831) 422-6750
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN280086
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
202
CA
Other
Enumeration date
03/23/2011
Last updated
03/23/2011
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