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Individual
AVERY JOHN PAULSON
Active
Individual
AVERY JOHN PAULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
686849
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95024036
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
12/19/2018
Last updated
06/02/2023
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