Individual
LAURA WITHOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
890 W STETSON AVE STE B, HEMET, CA 92543-7311
(951) 764-2495
Mailing address
35167 SLATER AVE, WINCHESTER, CA 92596-8799
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95029172
CA
Other
Enumeration date
04/08/2024
Last updated
04/08/2024
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