Provider Demographics
NPI:1750512885
Name:MALGESINI, NANETTE (NP)
Entity type:Individual
Prefix:
First Name:NANETTE
Middle Name:
Last Name:MALGESINI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 BLAKE WILBUR DRIVE, M/C 5358
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94304
Mailing Address - Country:US
Mailing Address - Phone:650-498-7870
Mailing Address - Fax:650-498-7873
Practice Address - Street 1:900 BLAKE WILBUR DRIVE, M/C 5358
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94304-2201
Practice Address - Country:US
Practice Address - Phone:650-498-7870
Practice Address - Fax:650-498-7873
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2011-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18841363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily