Individual
CAROL JEAN S. RUENPROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN, PHN
Contact information
Practice address
523 N CHARDONNAY DR, COVINA, CA 91723-1564
(209) 814-4271
Mailing address
523 N CHARDONNAY DR, COVINA, CA 91723-1564
(209) 814-4271
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN500394
CA
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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