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Nursing Service Providers Registered Nurse

Provider NPI: 1629445283

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 916-396-2345  Fax: --

Business Mailing Address:
Tel: 916-396-2345  Fax: --

NPI Information:
NPI: 1629445283
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
N163W00000XNursing Service Providers
Registered Nurse
N163WD1100XNursing Service Providers
Registered Nurse
Y163WH0500XNursing Service Providers
Registered Nurse

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 163WH0500X





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