Individual
MRS. CHANCE THEPMONTRY-NHEP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
245 TERRACINA BLVD STE 102, REDLANDS, CA 92373-4865
(909) 792-2605
Mailing address
PO BOX 10069, SAN BERNARDINO, CA 92423-0069
(909) 335-4188
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
NP95015055
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95015055
—
CA
Enumeration date
08/30/2020
Last updated
10/29/2021
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