Individual
MRS. DIANE CAROL FENNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
12041 JONATHAN DR, RIVERSIDE, CA 92503-5946
(951) 312-9250
(951) 352-3738
Mailing address
12041 JONATHAN DR, RIVERSIDE, CA 92503-5946
(951) 312-9250
(951) 352-3738
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
396779
CA
Other
Enumeration date
05/05/2011
Last updated
05/05/2011
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