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Individual

DAWN IRENE BLUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
55887 YUCCA VALLEY TRAIL, YUCCA VALLEY, CA 92284
(760) 447-1200
Mailing address
60205 CHESAPEAKE DR, JOSHUA TREE, CA 92252-2788
(760) 447-1200

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
391944
CA
363LA2100X
Acute Care Nurse Practitioner
95012600
CA
363LA2200X
Adult Health Nurse Practitioner
Primary
95012600
CA
363LG0600X
Gerontology Nurse Practitioner
95012600
CA

Other

Enumeration date
09/04/2019
Last updated
09/04/2019
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