Organization
FIDELITY NURSING PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD FIDEL SEVILLA NURSE PRACTITIONER (NURSE PRACTITIONER)
(209) 470-8575
Entity
Organization
Contact information
Practice address
2004 AUTUMN OAK PL, STOCKTON, CA 95209-4230
(209) 470-8575
Mailing address
2004 AUTUMN OAK PL, STOCKTON, CA 95209-4230
(209) 470-8575
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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