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General NPI Number Information
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NPI Number | 1871300301
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Entity Type | Organization
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Legal Business Name | ADVANCE NURSING PRACTICE MEDICAL GROUP INC
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 809 SYLVAN AVE STE 400
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City | MODESTO
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State | CA
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Zip | 95350-1500
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Country | US
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Telephone | 209-567-2576
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Fax | 209-567-2591
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Provider Business Mailing Address
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Address Line | 600 WALNUT WOODS CT
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City | MODESTO
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State | CA
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Zip | 95356-9656
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Country | US
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Telephone | 209-567-2576
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Fax | 209-567-2591
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | JOSELYN ARANDIA DECULING
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Credential | FNP
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Telephone | 209-531-8650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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