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SURANI HAYRE-KWAN FNP
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1134135924
Individual Registrant: SURANI HAYRE-KWAN FNP
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
16319 THIRD STREET GUERNEVILLE, CA 95446 US
Tel: 707-869-2849 Fax: 707-869-1477
Tel: 707-869-2849 Fax: 707-869-1477
Contact information for business:
PO BOX 1449 GUERNEVILLE, CA 95446-1449 US
Tel: 707-869-5977 Fax: 707-869-5983
Tel: 707-869-5977 Fax: 707-869-5983
Registration Information:
NPI: 1134135924
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 | NP504240 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| MEDICARE PART B | ZZZ73222Z | 01 | |
| 1356344758 | CA | 05 | |
| STATE LICENSE NUMBER | NP504240 | CA | 01 |
