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1417456351
PHYLLIS CRISOSTOMO CARROLL
NOVATO, CA
NPI
1417456351
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 9008368)
Enumeration Date
2018-02-06
Last Update Date
2018-02-06
Business Address
PHYLLIS CRISOSTOMO CARROLL FNP-C
6100 REDWOOD BLVD
NOVATO, CA 94945-4501
Phone number: 415-448-1500
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Mailing Address
PHYLLIS CRISOSTOMO CARROLL FNP-C
405 HOLLY DR
SAN RAFAEL, CA 94903-2441
Phone number: 510-520-0488
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