Individual
NICOLE CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1600 EUREKA RD, ROSEVILLE, CA 95661-3027
(916) 474-6687
Mailing address
1403 BLOSSOM HILL WAY, ROSEVILLE, CA 95661-5491
(916) 890-6441
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
CPT-02198243
CA
Other
Enumeration date
07/21/2022
Last updated
07/21/2022
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