Individual
MS. FAYE WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.V.N
Contact information
Practice address
300 E 15TH ST, MERCED, CA 95341-6217
(209) 381-6879
Mailing address
PO BOX 2087, MERCED, CA 95344-0087
(209) 381-6879
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
291954
CA
Other
Enumeration date
10/11/2022
Last updated
10/11/2022
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