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Individual

DANIELLE JENAE POULIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1100 W STEWART DR, ORANGE, CA 92868-3849
(714) 633-9111
Mailing address
PO BOX 690, LONG BEACH, CA 90801-0690
(562) 809-3547

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
524440
CA
363L00000X
Nurse Practitioner
Primary
17297
CA

Other

Enumeration date
10/06/2008
Last updated
10/06/2008
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