Individual
TREVR W EBORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3327 TAYLOR DR, LEMOORE, CA 93245-3561
(202) 251-8314
Mailing address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 542-7856
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
N-31635
ID
367500000X
Certified Registered Nurse Anesthetist
Primary
NA95001023
CA
Other
Enumeration date
02/20/2009
Last updated
08/23/2019
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