Individual
AMY LAUREN KOLESIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.-C
Contact information
Practice address
10565 CIVIC CENTER DR BLDG SUITE165, RANCHO CUCAMONGA, CA 91730-3853
(909) 985-2211
(909) 985-2244
Mailing address
10565 CIVIC CENTER DR BLDG SUITE165, RANCHO CUCAMONGA, CA 91730-3853
(909) 985-2211
(909) 985-2244
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95010259
CA
Other
Enumeration date
11/06/2007
Last updated
04/09/2019
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