Healthcare Provider Details

I. General information

NPI: 1033694211
Provider Name (Legal Business Name): KRISTI LYNN MEFFORD RN, PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2018
Last Update Date: 10/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W CYPRESS AVE
VISALIA CA
93277-8300
US

IV. Provider business mailing address

39283 ROAD 74
DINUBA CA
93618-9745
US

V. Phone/Fax

Practice location:
  • Phone: 559-730-7781
  • Fax:
Mailing address:
  • Phone: 559-967-4761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number835520
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: