Provider Demographics
NPI:1235251158
Name:PASSMORE, VERONICA MARIE (RN, APRN-BC)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:MARIE
Last Name:PASSMORE
Suffix:
Gender:F
Credentials:RN, APRN-BC
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:MARIE
Other - Last Name:BRAZEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, APRN-BC
Mailing Address - Street 1:5 DEER SPG
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-3011
Mailing Address - Country:US
Mailing Address - Phone:760-321-2095
Mailing Address - Fax:
Practice Address - Street 1:1150 N INDIAN CANYON DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4872
Practice Address - Country:US
Practice Address - Phone:760-323-6430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16579363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily