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Individual

CAROL JANE MANNERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
81719 DR CARREON BLVD STE A, INDIO, CA 92201-5518
(760) 347-0707
(760) 347-3378
Mailing address
78617 BENT CANYON CT, BERMUDA DUNES, CA 92203-1058
(614) 579-5616

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95014644
CA

Other

Enumeration date
06/01/2020
Last updated
08/03/2020
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