Individual
MS. TINA MARIE SUDDUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
14191 YALE ST, HESPERIA, CA 92344-8290
(909) 855-1545
Mailing address
14191 YALE ST, HESPERIA, CA 92344-8290
(909) 855-1545
Taxonomy
Speciality
Code
Description
License number
State
163WN0003X
Low-Risk Neonatal Registered Nurse
Primary
396021
CA
Other
Enumeration date
01/12/2011
Last updated
01/12/2011
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