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NPI Code Detail

MEDICARE: MISS RASHILDA AYANNA STORM MSN, AGPCNP-BC

MEDICARE: MISS RASHILDA AYANNA STORM MSN, AGPCNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerF306806-1NY
2363LG0600XGerontology Nurse PractitionerF340948-1NY
3163W00000XRegistered NurseRN95091386CA
4363LG0600XGerontology Nurse PractitionerNP95004311CA

General Provider Information

NPI Number : 1033520820
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS RASHILDA AYANNA STORM MSN, AGPCNP-BC
Provider Business Mailing Address
First Line : 737 W CHILDS AVE
Second Line :
City : MERCED
State : CA
Zip : 95341-6805
Country : US
Telephone Number : 209-384-6493
Fax Number :
Provider Business Practice Location Address
First Line : 857 W CHILDS AVE
Second Line : GERIATRICS
City : MERCED
State : CA
Zip : 95341-6862
Country : US
Telephone Number : 209-385-5600
Fax Number : 209-385-5674
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2014
Last Update Date : 08/23/2016

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Directions to “ MISS RASHILDA AYANNA STORM MSN, AGPCNP-BC” Practice Location

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