Provider Demographics
NPI:1487655841
Name:SHRIMPTON, MARY SUSAN (RNFA)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:SUSAN
Last Name:SHRIMPTON
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5260 ZINFANDEL LN
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-8391
Mailing Address - Country:US
Mailing Address - Phone:415-453-3220
Mailing Address - Fax:415-453-3220
Practice Address - Street 1:5260 ZINFANDEL LN
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-8391
Practice Address - Country:US
Practice Address - Phone:415-453-3220
Practice Address - Fax:415-453-3220
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN467911174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist