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NPI Code Detail

MEDICARE: JANUARY TIU FNP-C

MEDICARE: JANUARY TIU 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 Practitioner22995CA

General Provider Information

NPI Number : 1427483452
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANUARY TIU FNP-C
Provider Business Mailing Address
First Line : 43322 GINGHAM AVE
Second Line : SUITE 104
City : LANCASTER
State : CA
Zip : 93535-4576
Country : US
Telephone Number : 661-874-4050
Fax Number :
Provider Business Practice Location Address
First Line : 43322 GINGHAM AVE
Second Line : SUITE 104
City : LANCASTER
State : CA
Zip : 93535-4576
Country : US
Telephone Number : 661-874-4050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2013
Last Update Date : 12/15/2021

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Directions to “ JANUARY TIU FNP-C” Practice Location

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