Healthcare Provider Details

I. General information

NPI: 1902062409
Provider Name (Legal Business Name): ELIZABETH SEHNERT REX NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2008
Last Update Date: 08/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE L171 BOX 0210
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

1352 PARKWAY DR
PARADISE CA
95969-6402
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1565
  • Fax: 415-353-1202
Mailing address:
  • Phone: 530-872-0926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number336433
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: