Individual
HOLLY CHAMPAGNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
117 HIGH ST, GRASS VALLEY, CA 95945-6401
(530) 477-1369
Mailing address
117 HIGH STREET, GRASS VALLEY, CA 95945-6401
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
314108
CA
364S00000X
Clinical Nurse Specialist
2771
CA
Other
Enumeration date
09/17/2010
Last updated
12/21/2021
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