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NPI Code Detail

MEDICARE: MRS. JONI LYNN STANTON RN

MEDICARE: MRS. JONI LYNN STANTON RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WG0000XGeneral Practice Registered Nurse95214709CA

General Provider Information

NPI Number : 1033731443
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JONI LYNN STANTON RN
Provider Business Mailing Address
First Line : 1317 CAMBON CT
Second Line :
City : REDLANDS
State : CA
Zip : 92374-5447
Country : US
Telephone Number : 909-205-4622
Fax Number :
Provider Business Practice Location Address
First Line : 11201 BENTON ST
Second Line :
City : LOMA LINDA
State : CA
Zip : 92357-1000
Country : US
Telephone Number : 909-825-7084
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2020
Last Update Date : 05/08/2020

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