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NPI Code Detail

MEDICARE: ROSETTA MELINDA WARE LVN

MEDICARE: ROSETTA MELINDA WARE LVN
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
1164X00000XLicensed Vocational Nurse293498CA

General Provider Information

NPI Number : 1396382701
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSETTA MELINDA WARE LVN
Provider Business Mailing Address
First Line : 7171 BOWLING DR STE 300
Second Line :
City : SACRAMENTO
State : CA
Zip : 95823-2043
Country : US
Telephone Number : 916-394-9195
Fax Number :
Provider Business Practice Location Address
First Line : 9340 E STOCKTON BLVD
Second Line :
City : ELK GROVE
State : CA
Zip : 95624-1563
Country : US
Telephone Number : 916-519-8198
Fax Number : 916-519-8199
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2019
Last Update Date : 03/07/2024

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Directions to “ ROSETTA MELINDA WARE LVN” Practice Location

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