Organization · Type 2 NPI
Illuminate Medical Inc
Psychiatric/Mental Health Nurse Practitioner · Corona, CA
NPI number
1043075112
Active
Practice location
7891 Slate Creek Rd
Corona, CA 92880-8544
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1043075112
Illuminate Medical Inc's National Provider Identifier is 1043075112, issued on Feb 19, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Corona, CA. The record was last updated on Feb 19, 2024.