Healthcare Provider Details

I. General information

NPI: 1235642851
Provider Name (Legal Business Name): NEOLA MARLENE ARMSTEAD NP, MSN, BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2017
Last Update Date: 11/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 STOCKTON BLVD
SACRAMENTO CA
95817-2201
US

IV. Provider business mailing address

5605 MINGEE WAY
ELK GROVE CA
95757-1647
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2000
  • Fax:
Mailing address:
  • Phone: 225-205-1144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number95003824
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: