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BIRHANU Z. ADMASSIE FNP

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

Registrant NPI Number: 1346715307

Individual Registrant:
 BIRHANU Z. ADMASSIE FNP
Gender: M
Sole Proprietor

Location and contact information for practice:
2122 W KETTLEMAN LN  LODI, CA 95242 US
Tel: 209-224-8517  Fax: --

Contact information for business:
4059 LOST CANYON COURT, HOUSE  ANTIOCH, CA 94531 US
Tel: 925-779-1982  Fax: --

Registration Information:
NPI: 1346715307
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
CA95009185

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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