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Individual

MISS ANNA OLIVIA FRAGOSO-NINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C-PNP

Contact information

Practice address
14446 TAWNEY RIDGE LN, VICTORVILLE, CA 92394-3210
(760) 221-4726
Mailing address
14446 TAWNEY RIDGE LN, VICTORVILLE, CA 92394-3210
(760) 221-4726

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
21714
CA

Other

Enumeration date
04/15/2014
Last updated
03/28/2022
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