Individual
MRS. JOHANNA LISETTE DEBRUYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, PHN
Contact information
Practice address
150 DISTRICT CENTER DR, PALM SPRINGS, CA 92264-3626
(760) 835-9836
(760) 325-8730
Mailing address
708 AMBER SKY ST, BANNING, CA 92220-3729
(909) 844-6563
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
802986
CA
Other
Enumeration date
02/15/2024
Last updated
02/15/2024
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