Individual
DIANA EWING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
327 COLLEGE AVE, SANTA ROSA, CA 95401-5117
(707) 531-2486
Mailing address
327 COLLEGE AVE, SANTA ROSA, CA 95401-5117
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
685423
CA
Other
Enumeration date
10/03/2024
Last updated
10/03/2024
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