Healthcare Provider Details

I. General information

NPI: 1023211463
Provider Name (Legal Business Name): FRANCES ROWENA MCCANN ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: F. ROWENA MCCANN

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11234 ANDERSON ST
LOMA LINDA CA
92354-2804
US

IV. Provider business mailing address

719 E 39TH ST
SAN BERNARDINO CA
92404-1859
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-8514
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number16692
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: