Individual
MRS. JOAN MAYRE RENFROE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN, IP, DSD
Contact information
Practice address
699 WINNERS CIR, SAN JACINTO, CA 92582-2741
(951) 487-3815
Mailing address
2147 SAINT MICHELE, SAN JACINTO, CA 92583-5737
(813) 952-7750
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
PN5199749
FL
164X00000X
Licensed Vocational Nurse
Primary
708453
CA
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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