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NPI Code Detail

MEDICARE: MS. ANNA LOUISE ROURKE NP

MEDICARE: MS. ANNA LOUISE ROURKE NP
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
1163W00000XRegistered Nurse810389CA
2363LF0000XFamily Nurse Practitioner95003673CA

General Provider Information

NPI Number : 1427426568
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANNA LOUISE ROURKE NP
Provider Business Mailing Address
First Line : 219 NEWPORT AVE APT 4
Second Line :
City : LONG BEACH
State : CA
Zip : 90803-5935
Country : US
Telephone Number : 206-446-6769
Fax Number :
Provider Business Practice Location Address
First Line : 2841 LOMITA BLVD STE 100
Second Line :
City : TORRANCE
State : CA
Zip : 90505-5100
Country : US
Telephone Number : 310-257-0508
Fax Number : 310-325-8109
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2015
Last Update Date : 04/09/2021

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