Healthcare Provider Details

I. General information

NPI: 1205470929
Provider Name (Legal Business Name): ZOUAPA KALANI VUE FNP MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2019
Last Update Date: 01/06/2021
Certification Date: 12/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2042 KERN ST
FRESNO CA
93721-2008
US

IV. Provider business mailing address

3137 N BURL AVE
FRESNO CA
93727-8915
US

V. Phone/Fax

Practice location:
  • Phone: 559-400-6420
  • Fax:
Mailing address:
  • Phone: 559-476-6030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number689800
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNPF95014887
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: