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1699462614
JONATHAN KITISAK POWELL
FAIRFIELD, CA
NPI
1699462614
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: CA 95317597)
Enumeration Date
2023-04-19
Last Update Date
2023-04-19
Business Address
JONATHAN KITISAK POWELL BSN, RN
470 CHADBOURNE RD STE A
FAIRFIELD, CA 94534-9620
Phone number: 707-419-8989
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Mailing Address
JONATHAN KITISAK POWELL BSN, RN
304 STAMPER CIR
SUISUN CITY, CA 94585-4104
Phone number: 707-722-7553
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