Basic Information
| Provider Information | |||||||||
| NPI: | 1952445827 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAW | ||||||||
| FirstName: | GINA | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | R.N., RNFA, FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2922 ALDERGROVE CT | ||||||||
| Address2: | |||||||||
| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928354327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142551076 | ||||||||
| FaxNumber: | 7142551076 | ||||||||
| Practice Location | |||||||||
| Address1: | 2922 ALDERGROVE CT | ||||||||
| Address2: | |||||||||
| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928354327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142551076 | ||||||||
| FaxNumber: | 7142551076 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2007 | ||||||||
| LastUpdateDate: | 03/17/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WR0006X | 467998 | CA | N | Nursing Service Providers | Registered Nurse | Registered Nurse First Assistant | 363LF0000X | 18492 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.