Provider Demographics
NPI:1396825220
Name:SCURKA, GWENDOLYN MARIE (NP)
Entity Type:Individual
Prefix:MISS
First Name:GWENDOLYN
Middle Name:MARIE
Last Name:SCURKA
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1643 WORTELL DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-3113
Mailing Address - Country:US
Mailing Address - Phone:916-783-1080
Mailing Address - Fax:916-783-1090
Practice Address - Street 1:508 GIBSON DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-5794
Practice Address - Country:US
Practice Address - Phone:916-783-1080
Practice Address - Fax:916-783-1090
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2014-09-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA16718207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine