Individual
VENIECE DELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
508 GIBSON DR STE 220, ROSEVILLE, CA 95678-5796
(916) 773-5577
Mailing address
508 GIBSON DR STE 220, ROSEVILLE, CA 95678-5796
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95015947
CA
Other
Enumeration date
12/08/2020
Last updated
12/08/2020
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