MICAH LEON CHILDRESS

ROCKLIN, CA
NPI1063291847
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LA2100X Nurse Practitioner, Acute Care
(Licence: CA  95027332)
Enumeration Date2023-09-21
Last Update Date2023-09-21
Business Address
MICAH LEON CHILDRESS
2340 SUNSET BLVD #100 STUDIO 23
ROCKLIN, CA 95765
Phone number: 903-918-3016
Mailing Address
MICAH LEON CHILDRESS
1331 LARKSPUR DR
ROCKLIN, CA 95765-5593
Phone number: 903-918-3016