Individual
ANDREA MARCIA ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NP
Contact information
Practice address
1245 WILSHIRE BLVD, SUITE 703, LOS ANGELES, CA 90017-4810
(213) 977-0419
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(213) 977-0419
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
17534
CA
Other
Enumeration date
12/05/2008
Last updated
11/27/2023
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