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Individual

MRS. DAPHNE MAE CARRIGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LVN

Contact information

Practice address
11614 ANDERSON ST, LOMA LINDA, CA 92354-3457
(909) 754-1128
(909) 894-4700
Mailing address
11614 ANDERSON ST, LOMA LINDA, CA 92354-3457
(909) 754-1128
(909) 894-4700

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
150838
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
150838
CA
Enumeration date
07/03/2020
Last updated
07/03/2020
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