JESSICA SUSAN CARBALLO

FORT IRWIN, CA
NPI1285222398
Former NameJESSICA SUSAN MANN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367A00000X Advanced Practice Midwife
(Licence: WA  AP61176629)
Additional Taxonomies163WM0102X Registered Nurse, Maternal Newborn
(Licence: WA  RN60857557)
Enumeration Date2021-01-05
Last Update Date2024-08-02
Business Address
JESSICA SUSAN CARBALLO CNM
BLDG 390 N LOOP RD
FORT IRWIN, CA 92310
Phone number: 760-383-5155
Mailing Address
JESSICA SUSAN CARBALLO CNM
390 N LOOP RD
FORT IRWIN, CA 92310
Phone number: