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1194573402
JENELLE IM
FAIRFIELD, CA
NPI
1194573402
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164X00000X Licensed Vocational Nurse
(Licence: CA 686758)
Enumeration Date
2024-05-10
Last Update Date
2024-05-10
Business Address
JENELLE IM
2101 COURAGE DR
FAIRFIELD, CA 94533-6717
Phone number: 707-428-1131
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Mailing Address
JENELLE IM
2101 COURAGE DR
FAIRFIELD, CA 94533-6717
Phone number:
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