MARIE LYN CUSTODIO NURSE PRACTITIONER NPI 1356981526

NPI Information

Marie Lyn Custodio, NURSE PRACTITIONER is a family nurse practitioner in San Diego, CA. Marie Lyn Custodio, NURSE PRACTITIONER NPI is 1356981526. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3327 ROSECRANS ST
SAN DIEGO, CA
ZIP 92110-223
Phone: (619) 225-9691

The NPI 1356981526 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/15/2020 and was last updated on 10/21/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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