Provider Demographics
NPI:1295010866
Name:BILBRO, MARY THERESA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:THERESA
Last Name:BILBRO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 WASHINGTON ST # B141
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3050
Mailing Address - Country:US
Mailing Address - Phone:831-331-6745
Mailing Address - Fax:
Practice Address - Street 1:10 HARRIS CT BLDG A
Practice Address - Street 2:STE A1
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5704
Practice Address - Country:US
Practice Address - Phone:831-643-9788
Practice Address - Fax:831-657-0161
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-14
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA602555163W00000X
CANP95001838363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse