Individual provider · Type 1 NPI
James Robert Etteldorf, N.P.
Family Nurse Practitioner · Loma Linda, CA
NPI number
1164559761
Active
Practice location
11234 Anderson St
Loma Linda, CA 92354-2804
Mailing address
2242 Black Oak Pl
Riverside, CA 92506-4603
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 10542 (CA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1164559761
James Robert Etteldorf, N.P.'s National Provider Identifier is 1164559761, issued on Feb 28, 2007. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Loma Linda, CA. The record was last updated on Jul 8, 2007.