Individual
JAN CHEYANNE PUNSAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
14426 GILMORE ST STE B, VAN NUYS, CA 91401-1429
(818) 614-3713
Mailing address
14426 GILMORE ST STE B, VAN NUYS, CA 91401-1429
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95016508
CA
Other
Enumeration date
09/22/2021
Last updated
09/22/2021
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