Individual
DR. EBONY NICOLE FUNCHES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C, AG-ACNP
Contact information
Practice address
604 ROSE AVE, VENICE, CA 90291-2767
(310) 392-8636
(310) 392-6642
Mailing address
604 ROSE AVE, VENICE, CA 90291-2767
(310) 392-8636
(310) 392-6642
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95002049
CA
Other
Enumeration date
02/03/2015
Last updated
02/16/2021
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