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General NPI Number Information
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NPI Number | 1063279842
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Entity Type | Organization
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Legal Business Name | NIGHTINGALE NURSING WELLNESS
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Dates
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Enumeration Date | 02/28/2024
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 16935 W BERNARDO DR STE 140
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City | SAN DIEGO
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State | CA
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Zip | 92127-1664
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Country | US
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Telephone | 858-225-4691
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Fax |
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Provider Business Mailing Address
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Address Line | 16935 W BERNARDO DR STE 140
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City | SAN DIEGO
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State | CA
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Zip | 92127-1664
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Country | US
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Telephone | 858-225-4691
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER GATHMAN
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Credential | NP, IBCLC
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Telephone | 858-225-4691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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