Individual
BUNGA MAYTHRESA SIAHAAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
14437 E 1ST DR APT C10, AURORA, CO 80011-8777
(951) 380-6965
Mailing address
14437 E 1ST DR APT C10, AURORA, CO 80011-8777
(951) 380-6965
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.1672616
CO
Other
Enumeration date
06/05/2021
Last updated
06/05/2021
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