Individual
LORI NICOLE GREYDANUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11487 DONNER PASS CT, RANCHO CUCAMONGA, CA 91737-6533
(909) 519-0105
Mailing address
11487 DONNER PASS CT, RANCHO CUCAMONGA, CA 91737-6533
(909) 519-0105
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
95034429
CA
Other
Enumeration date
04/12/2025
Last updated
04/12/2025
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