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DILLAN NICOLE FIRESTONE

Surgical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1508352790

Individual Registrant:
 DILLAN NICOLE FIRESTONE 
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: --

Contact information for business:
761 FULTON LN  SAINT HELENA, CA 94574-1016 US
Tel: 480-254-9145  Fax: --

Registration Information:
NPI: 1508352790
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363AS0400XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
Surgical
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
CAPA56930

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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