Individual
AGNES R FELICANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
180 SIERRA COLLEGE DR, GRASS VALLEY, CA 95945-5768
(530) 460-2592
Mailing address
180 SIERRA COLLEGE DR, GRASS VALLEY, CA 95945-5768
(530) 460-2592
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP13077
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP13077
NP13077
CA
Enumeration date
08/03/2010
Last updated
11/04/2024
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