Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Marietta Formoso Light, NP-C

Individual provider Family Nurse Practitioner · NPI 1750368650

Marietta Formoso Light, NP-C is a Family Nurse Practitioner in Clovis, California. Works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2005
Specialties on file
3
What do these letters mean?
NP-C — Nurse Practitioner, Certified
A nurse practitioner certified by the AANP.

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Practice location Address checks out

782 Medical Center Dr E Ste 212
Clovis, CA 93611-6889
Phone: (559) 451-3676
Fax: (559) 451-3680
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 782 Medical Center Dr E # 212, Clovis, CA 93611-6889 — (559) 451-3676

Specialties & licences

Obstetrics & Gynecology Nurse Practitioner (primary) Taxonomy 363LX0001X · Licence 6030 (CA)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 6030 (CA)
Women's Health Nurse Practitioner Taxonomy 363LW0102X · Licence 6030 (CA)

Record details

NPI number1750368650
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP-C
Sole proprietorNo
NPI enumeratedDecember 30, 2005
Last updated in NPPESOctober 8, 2020
Certification dateOctober 8, 2020

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