Individual provider · Type 1 NPI

Marie Lyn Custodio, NURSE PRACTITIONER

Family Nurse Practitioner · San Diego, CA

NPI number 1356981526 Active

Practice location

3327 Rosecrans St
San Diego, CA 92110-4223

Other practice locations

  • 1419 E 8th St, National City, CA 91950-2602 · (619) 718-1743
  • 2760 Fletcher Pkwy, El Cajon, CA 92020-2110 · (619) 461-4411

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner 363L00000X80555 (CA)
Family Nurse Practitioner Primary 363LF0000X95013240 (CA)

Family Nurse Practitioner: Definition to come...

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About NPI 1356981526

Marie Lyn Custodio, NURSE PRACTITIONER's National Provider Identifier is 1356981526, issued on Jan 15, 2020. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in San Diego, CA. The record was last updated on Oct 21, 2021.