Provider Demographics
NPI:1114146636
Name:THORNTON, MARCY L (RNP)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:L
Last Name:THORNTON
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7910 FROST STREET
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2753
Mailing Address - Country:US
Mailing Address - Phone:858-277-9378
Mailing Address - Fax:858-277-9370
Practice Address - Street 1:7910 FROST STREET
Practice Address - Street 2:SUITE 400
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2753
Practice Address - Country:US
Practice Address - Phone:858-277-9378
Practice Address - Fax:858-277-9370
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA342596363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7382OtherNP FURNISHING NUMBER