Individual
MS. ANN NICOLA-JORDAN CAVANAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP,PA-C
Contact information
Practice address
5701 S. HOOVER ST., LOS ANGELES, CA 90037
(323) 541-1400
(323) 541-1401
Mailing address
403 W 40TH ST, SAN PEDRO, CA 90731-7103
(310) 547-0087
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
401219NP6265
CA
Other
Enumeration date
12/01/2006
Last updated
07/08/2007
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