Healthcare Provider Details

I. General information

NPI: 1710466347
Provider Name (Legal Business Name): NORAH NASSAR BUENAFLOR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2018
Last Update Date: 08/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 FULTON AVE STE 205
SACRAMENTO CA
95825-4517
US

IV. Provider business mailing address

900 FULTON AVE STE 205
SACRAMENTO CA
95825-4517
US

V. Phone/Fax

Practice location:
  • Phone: 916-484-3570
  • Fax:
Mailing address:
  • Phone: 916-484-3570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number626256
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: