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Individual

GANNA YUSUPOVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP-BC

Contact information

Practice address
1009 DYER DR, LAFAYETTE, CA 94549-4652
(415) 306-2133
Mailing address
1009 DYER DR, LAFAYETTE, CA 94549-4652
(415) 306-2133

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
NP95031544
CA

Other

Enumeration date
10/08/2024
Last updated
10/08/2024
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