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1063291847
MICAH LEON CHILDRESS
ROCKLIN, CA
NPI
1063291847
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LA2100X Nurse Practitioner, Acute Care
(Licence: CA 95027332)
Enumeration Date
2023-09-21
Last Update Date
2023-09-21
Business Address
MICAH LEON CHILDRESS
2340 SUNSET BLVD #100 STUDIO 23
ROCKLIN, CA 95765
Phone number: 903-918-3016
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Mailing Address
MICAH LEON CHILDRESS
1331 LARKSPUR DR
ROCKLIN, CA 95765-5593
Phone number: 903-918-3016
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