Individual provider · Type 1 NPI
Alice Lane Therrell, RN, FNP-BC
Family Nurse Practitioner · Fairfield, CA
NPI number
1174953368
Active
Practice location
4160 Suisun Valley Rd #132
Fairfield, CA 94534
Mailing address
PO Box 1198-1379
Sacramento, CA 95812
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 797771 (CA) |
| Family Nurse Practitioner Primary | 363LF0000X | 23149 (CA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1174953368
Alice Lane Therrell, RN, FNP-BC's National Provider Identifier is 1174953368, issued on Nov 25, 2013. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Fairfield, CA. The record was last updated on Nov 25, 2013.