Individual provider · Type 1 NPI

Roshally Elvy Hutabarat, LVN

Licensed Vocational Nurse · San Bernardino, CA

NPI number 1679760573 Active

Practice location

264 E 18th St
San Bernardino, CA 92404-4708

Call (909) 883-0288 Map

Mailing address

25502 Portola Loop
Loma Linda, CA 92354

Specialties and licenses

Taxonomy	Code	License
Licensed Vocational Nurse Primary	164X00000X	VA 209395 (CA)

Licensed Vocational Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. [An alternate term for licensed practical nurse arising from difference in occupational titles between states and post-high school training programs and institutions.] Requirements for education, experience, licensure, and job re…

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About NPI 1679760573

Roshally Elvy Hutabarat, LVN's National Provider Identifier is 1679760573, issued on Sep 25, 2007. The primary taxonomy on file is Licensed Vocational Nurse (164X00000X), and the practice location is in San Bernardino, CA. The record was last updated on Sep 25, 2007.