Individual
LAUREL WOOD IMPASTATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(909) 558-4711
Mailing address
1495 KINCAID ST, REDLANDS, CA 92373-6931
(909) 792-5504
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
376586
CA
Other
Enumeration date
02/23/2007
Last updated
07/08/2007
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