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NESREN ANTON AZER ANTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
3509 COFFEE RD, MODESTO, CA 95355-1356
(510) 736-9104
Mailing address
582 E HARDING WAY, STOCKTON, CA 95204-6110
(510) 736-9104

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
95011844
CA

Other

Enumeration date
05/22/2019
Last updated
08/27/2021
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