Individual
CHEYENNE DEROUEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
47825 OASIS ST, INDIO, CA 92201-6950
(760) 863-8145
(760) 863-8587
Mailing address
47825 OASIS ST, INDIO, CA 92201-6950
(760) 863-8145
(760) 863-8587
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
687631
CA
Other
Enumeration date
02/20/2018
Last updated
02/20/2018
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