Individual
MASSANU ARISBE SIRLEAF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1351 BROADWAY, EL CAJON, CA 92021-5811
(414) 704-3022
(619) 567-2455
Mailing address
PO BOX 15788, SAN DIEGO, CA 92175-5788
(858) 278-8110
(858) 810-7196
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
236467
NC
363LA2100X
Acute Care Nurse Practitioner
5004684
NC
363LA2100X
Acute Care Nurse Practitioner
9237954
FL
363LA2100X
Acute Care Nurse Practitioner
Primary
95000692
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962725382
—
NC
05
—
7005200
—
NC
01
—
CB248737
MEDICARE PTAN
CA
05
—
NP1617
—
SC
Enumeration date
03/12/2010
Last updated
09/28/2020
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