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MICHELLE MARLYS SOUTH LVN

>> Licensed Vocational Nurse >> Nursing Service Providers

Registrant NPI Number: 1699045450

Individual Registrant:
 MICHELLE MARLYS SOUTH LVN
Gender: F
Sole Proprietor

Location and contact information for practice:
18285 CHINA GRADE RD #3 BOULDER CREEK, CA 95006-9188 US
Tel: 831-419-3116  Fax: --

Contact information for business:
18285 CHINA GRADE RD SPC 3  BOULDER CREEK, CA 95006-9100 US
Tel: 831-419-3116  Fax: --

Registration Information:
NPI: 1699045450
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y164X00000XNursing Service Providers
Licensed Vocational Nurse
CA220999

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS CA - Page 1



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