Individual
EENA SAESEE-NOI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
400 W MINERAL KING AVE, VISALIA, CA 93291-6237
(559) 624-2000
Mailing address
400 W MINERAL KING AVE, VISALIA, CA 93291-6237
(559) 624-2000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95011177
CA
363LP2300X
Primary Care Nurse Practitioner
95011177
CA
Other
Enumeration date
02/21/2019
Last updated
02/21/2019
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