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DILLAN NICOLE FIRESTONE
Surgical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1508352790
Individual Registrant: DILLAN NICOLE FIRESTONE
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
6 WOODLAND RD STE 202 SAINT HELENA, CA 94574 US
Tel: 707-968-0670 Fax: --
Tel: 707-968-0670 Fax: --
Contact information for business:
761 FULTON LN SAINT HELENA, CA 94574-1016 US
Tel: 480-254-9145 Fax: --
Tel: 480-254-9145 Fax: --
Registration Information:
NPI: 1508352790
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Surgical | ||
| Y | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | CA | PA56930 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
