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BIRHANU Z. ADMASSIE FNP
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1346715307
Individual Registrant: BIRHANU Z. ADMASSIE FNP
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
2122 W KETTLEMAN LN LODI, CA 95242 US
Tel: 209-224-8517 Fax: --
Tel: 209-224-8517 Fax: --
Contact information for business:
4059 LOST CANYON COURT, HOUSE ANTIOCH, CA 94531 US
Tel: 925-779-1982 Fax: --
Tel: 925-779-1982 Fax: --
Registration Information:
NPI: 1346715307
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | CA | 95009185 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
