Individual
MEGAN MARIE PARENT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
4TH ST, FORT IRWIN, CA 92310
(760) 380-3185
Mailing address
76 GRENADA WAY, FORT IRWIN, CA 92310-1721
Taxonomy
Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
Primary
89595
SC
Other
Enumeration date
04/17/2006
Last updated
07/08/2007
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