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NPI Code Detail

MEDICARE: MRS. PRUDENCE IONA STENNETT-ANDERSON FNPC

MEDICARE: MRS. PRUDENCE IONA STENNETT-ANDERSON FNPC
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 Practitioner583572CA

General Provider Information

NPI Number : 1396935938
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PRUDENCE IONA STENNETT-ANDERSON FNPC
Provider Business Mailing Address
First Line : 1543 E PALMDALE BLVD
Second Line : STE C
City : PALMDALE
State : CA
Zip : 93550-2000
Country : US
Telephone Number : 661-274-1200
Fax Number : 661-274-1199
Provider Business Practice Location Address
First Line : 1543 E PALMDALE BLVD
Second Line : STE C
City : PALMDALE
State : CA
Zip : 93550-2000
Country : US
Telephone Number : 661-274-1200
Fax Number : 661-274-1199
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2007
Last Update Date : 02/07/2011

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Directions to “ MRS. PRUDENCE IONA STENNETT-ANDERSON FNPC” Practice Location

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