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BREONA S BEVERLY
>> Licensed Vocational Nurse >> Nursing Service ProvidersRegistrant NPI Number: 1194243626
Individual Registrant: BREONA S BEVERLY
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
1904 RICHLAND AVE CERES, CA 95307-4562 US
Tel: 209-300-8800 Fax: --
Tel: 209-300-8800 Fax: --
Contact information for business:
1123 CEDAR CREEK DR UNIT 4 MODESTO, CA 95355-5228 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1194243626
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 164X00000X | Nursing Service Providers Licensed Vocational Nurse | CA | 688761 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
