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Individual

CHRISANN FORET

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
2240 EAST WINROW AVE, FORT HUACHUCA, AZ 85613
(520) 533-9034
(520) 533-5148
Mailing address
207 ELGIN ST, HUACHUCA CITY, AZ 85616-9731
(520) 533-9034

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP044683
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LP044683
PRACTIAL NURSE LICENSE NUMBER
AZ
Enumeration date
02/15/2016
Last updated
02/15/2016
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