Provider Demographics
NPI:1114128014
Name:MCENHILL, MARILYN ELIZATBETH (RN, PNP)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:ELIZATBETH
Last Name:MCENHILL
Suffix:
Gender:F
Credentials:RN, PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 4TH ST FL 6
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2350
Mailing Address - Country:US
Mailing Address - Phone:415-502-2794
Mailing Address - Fax:
Practice Address - Street 1:533 PARNASSUS AVE
Practice Address - Street 2:ROOM U585
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2208
Practice Address - Country:US
Practice Address - Phone:415-476-2423
Practice Address - Fax:415-476-9976
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA406620363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics