Individual
KATHERINE JEANNE STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
34952 GAIL AVE, YUCAIPA, CA 92399-2830
(909) 917-5504
Mailing address
34952 GAIL AVE, YUCAIPA, CA 92399-2830
(909) 917-5504
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
489727
CA
Other
Enumeration date
08/19/2020
Last updated
08/19/2020
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