Provider Demographics
NPI:1356523476
Name:STEINBERG, MARILYN LOUISE (CNM)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:LOUISE
Last Name:STEINBERG
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 685
Mailing Address - Street 2:46591 PICAYUNE CRK RD
Mailing Address - City:COARSEGOLD
Mailing Address - State:CA
Mailing Address - Zip Code:93614
Mailing Address - Country:US
Mailing Address - Phone:559-683-4456
Mailing Address - Fax:559-658-7877
Practice Address - Street 1:46591 PICAYUNE CREEK RD
Practice Address - Street 2:
Practice Address - City:COARSEGOLD
Practice Address - State:CA
Practice Address - Zip Code:93614
Practice Address - Country:US
Practice Address - Phone:559-683-4456
Practice Address - Fax:559-658-7877
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA229273163W00000X, 363LP0200X
685176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No176B00000XOther Service ProvidersMidwife
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANMW6850Medicaid