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General NPI Number Information
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NPI Number | 1245368653
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Entity Type | Organization
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Legal Business Name | A.WHITEBREAD RNFA
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 1702 SANDALWOOD DR
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City | MODESTO
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State | CA
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Zip | 95350-3819
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Country | US
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Telephone | 209-872-6316
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Fax |
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Provider Business Mailing Address
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Address Line | 1702 SANDALWOOD DR
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City | MODESTO
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State | CA
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Zip | 95350-3819
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Country | US
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Telephone | 209-872-6316
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE FIRST ASSIST
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Name | MISS ANNA MARIE WHITEBREAD
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Credential | R.N.F.A.
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Telephone | 209-872-6316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 411562
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License Number State | CA
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