Individual
HANNA ROSE FORDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
333 SKYWAY DR, CAMARILLO, CA 93010-8552
(805) 383-1155
Mailing address
333 SKYWAY DR, CAMARILLO, CA 93010-8552
(805) 383-1155
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95328724
CA
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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