Individual
ANNIE ROSE CONDOLON-KOHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4520 BUSINESS CENTER DR, FAIRFIELD, CA 94534-6888
(707) 646-5500
Mailing address
1724 ASHTREE CT, FAIRFIELD, CA 94534-3964
(484) 866-0654
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95011293
CA
Other
Enumeration date
04/13/2019
Last updated
04/13/2019
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