Individual
MS. ANNIE KANCHANASUWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, GNP, GCNS-BC
Contact information
Practice address
988 S FAIR OAKS AVE, PASADENA, CA 91105-2626
(626) 799-4193
Mailing address
3731 REVERE AVE, LOS ANGELES, CA 90039-1818
(323) 662-3007
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
15980
CA
Other
Enumeration date
04/22/2006
Last updated
01/30/2008
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