Provider Demographics
NPI:1952445827
Name:DAW, GINA MARIE (RN, RNFA, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:MARIE
Last Name:DAW
Suffix:
Gender:F
Credentials:RN, RNFA, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2922 ALDERGROVE CT
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-4327
Mailing Address - Country:US
Mailing Address - Phone:714-255-1076
Mailing Address - Fax:714-255-1076
Practice Address - Street 1:2922 ALDERGROVE CT
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-4327
Practice Address - Country:US
Practice Address - Phone:714-255-1076
Practice Address - Fax:714-255-1076
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA467998163WR0006X
CA18492363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant