Individual
STACIE LA JEUNESSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
844 OLD TUNNEL RD, GRASS VALLEY, CA 95945-8524
(530) 274-9762
(530) 273-7255
Mailing address
844 OLD TUNNEL RD, GRASS VALLEY, CA 95945-8524
(530) 274-9762
(530) 273-7255
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
300243
NC
Other
Enumeration date
02/26/2007
Last updated
11/30/2022
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