Individual
ANNICA DAWN PAGENKOPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 CHESTNUT AVE, RED BLUFF, CA 96080-2205
(530) 351-3521
Mailing address
PO BOX 400, RED BLUFF, CA 96080-0400
(530) 527-8491
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
693431
CA
Other
Enumeration date
05/08/2023
Last updated
05/08/2023
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