Healthcare Provider Details

I. General information

NPI: 1932254216
Provider Name (Legal Business Name): FRAN MALLOY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2516 STOCKTON BLVD
SACRAMENTO CA
95817-2208
US

IV. Provider business mailing address

9412 BULLION WAY
ORANGEVALE CA
95662-5425
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2250
  • Fax:
Mailing address:
  • Phone: 916-834-2051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0100X
TaxonomyGastroenterology Registered Nurse
License Number390988
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: