Healthcare Provider Details

I. General information

NPI: 1326756081
Provider Name (Legal Business Name): ARMESHA FLUKER LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2022
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16200 LASSELLE ST APT 132
MORENO VALLEY CA
92555-3049
US

IV. Provider business mailing address

231 E ALESSANDRO BLVD # 636
RIVERSIDE CA
92508-5084
US

V. Phone/Fax

Practice location:
  • Phone: 951-419-8349
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number873978
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN208282
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: