Individual
ISIOMA TRACY OKAFOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
14677 MERRILL AVE, FONTANA, CA 92335
(951) 943-2348
Mailing address
14677 MERRILL AVE, FONTANA, CA 92335
(951) 943-2348
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
40618
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
941735271
—
CA
Enumeration date
03/07/2019
Last updated
03/07/2019
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