Provider Demographics
NPI:1861649428
Name:CONTRERAS, MARIANNE (PA)
Entity Type:Individual
Prefix:MRS
First Name:MARIANNE
Middle Name:
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 N 32ND ST STE 105
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-4775
Mailing Address - Country:US
Mailing Address - Phone:602-279-2337
Mailing Address - Fax:602-230-9025
Practice Address - Street 1:4141 N 32ND ST STE 105
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-4775
Practice Address - Country:US
Practice Address - Phone:602-279-2337
Practice Address - Fax:602-230-9025
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical