ELAINE RENE ICENHOUR

EL DORADO HILLS, CA
NPI1689349391
Former NameELAINE RENE SHADY
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: CA  9800)
Enumeration Date2021-08-13
Last Update Date2021-08-13
Business Address
ELAINE RENE ICENHOUR
5220 ROBERT J MATHEWS PKWY
EL DORADO HILLS, CA 95762-5705
Phone number: 916-939-4960
Mailing Address
ELAINE RENE ICENHOUR
5220 ROBERT J MATHEWS PKWY
EL DORADO HILLS, CA 95762-5705
Phone number: 916-939-4960