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AGATA ANNA CHALFIN FNP

>> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1639533573

Individual Registrant:
 AGATA ANNA CHALFIN FNP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
3750 ROHNERVILLE ROAD  FORTUNA, CA 95540 US
Tel: 707-725-6101  Fax: 707-725-2978

Contact information for business:
670 9TH ST STE 203  ARCATA, CA 95521-6249 US
Tel: 707-826-8633  Fax: 707-826-8638

Registration Information:
NPI: 1639533573
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
NY340446
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
CA95009471

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS CA - Page 1



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