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NPI Code Detail

MEDICARE: CAROLYN LEGASPI APRN, FNP-C

MEDICARE: CAROLYN LEGASPI APRN, FNP-C
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
1363LF0000XFamily Nurse Practitioner95010003CA

General Provider Information

NPI Number : 1396212049
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN LEGASPI APRN, FNP-C
Provider Business Mailing Address
First Line : 3045 E FLORENCE AVE
Second Line :
City : HUNTINGTON PARK
State : CA
Zip : 90255-5837
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3045 E FLORENCE AVE
Second Line :
City : HUNTINGTON PARK
State : CA
Zip : 90255-5837
Country : US
Telephone Number : 323-587-7771
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2018
Last Update Date : 10/31/2018

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