Healthcare Provider Details

I. General information

NPI: 1427224336
Provider Name (Legal Business Name): ROXANN ELIZABETH MEKUS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 LONDON ST
SACRAMENTO CA
95822-3404
US

IV. Provider business mailing address

1400 LONDON ST
SACRAMENTO CA
95822-3404
US

V. Phone/Fax

Practice location:
  • Phone: 916-394-9579
  • Fax: 916-939-1959
Mailing address:
  • Phone: 916-394-9579
  • Fax: 916-939-1959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN494544
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: