MEDICARE: MISS EDITH ELIZABETH SANCHEZ RN

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
1	163W00000X	Registered Nurse	666424	CA

General Provider Information

NPI Number	:	1720774896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS EDITH ELIZABETH SANCHEZ RN

Provider Business Mailing Address
First Line	:	7720 SMOLEY WAY
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95610-2610
Country	:	US
Telephone Number	:	916-761-0249
Fax Number	:

Provider Business Practice Location Address
First Line	:	7720 SMOLEY WAY
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95610-2610
Country	:	US
Telephone Number	:	916-761-0249
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2023
Last Update Date	:	04/12/2023

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