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General NPI Number Information
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NPI Number | 1679753172
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Entity Type | Individual
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Provider Name | COLETTE MILLIE ALTOMAR RN, PHN
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Gender | Female
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 5730 PACKARD AVE STE 100
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City | MARYSVILLE
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State | CA
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Zip | 95901
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Country | US
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Telephone | 530-749-6767
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Fax | 530-749-6397
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Provider Business Mailing Address
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Address Line | 5730 PACKARD AVE STE 100 PO BOX 2320
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City | MARYSVILLE
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State | CA
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Zip | 95901
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Country | US
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Telephone | 530-749-6767
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Fax | 530-749-6397
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 182593
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License Number State | CA
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