Individual
MISS SUZETTE L PORNELOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2910 INLAND EMPIRE BLVD, ONTARIO, CA 91764-4896
(909) 522-4093
Mailing address
13393 MARIPOSA RD SPC 213, VICTORVILLE, CA 92395-5328
(760) 985-3259
Taxonomy
Speciality
Code
Description
License number
State
163WH1000X
Hospice Registered Nurse
Primary
786944
CA
Other
Enumeration date
09/03/2024
Last updated
09/03/2024
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