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Individual

MS. CHARISSE ANN DENNIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LVN

Contact information

Practice address
83-912 AVENUE 45, SUITE 8, INDIO, CA 92201-3338
(760) 347-0494
Mailing address
2140 MENTONE BLVD, SP 79, MENTONE, CA 92359-9703
(909) 794-3469

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN 195828
CA

Other

Enumeration date
04/06/2007
Last updated
07/08/2007
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