Individual
MRS. JAMIE LEE GORMLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Mailing address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95066330
CA
164X00000X
Licensed Vocational Nurse
VN263396
CA
Other
Enumeration date
05/16/2012
Last updated
09/03/2015
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