Individual
CHERISSE MARIE LACOSTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PHN
Contact information
Practice address
5730 PACKARD AVE, 100, MARYSVILLE, CA 95901-7118
(530) 749-6899
(530) 749-6397
Mailing address
5730 PACKARD AVE, 100, MARYSVILLE, CA 95901-7118
(530) 749-6899
(530) 749-6397
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
768128
CA
Other
Enumeration date
04/01/2010
Last updated
04/01/2010
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