Provider Demographics
NPI:1235855297
Name:NIGHTINGALE CENTER FOR ADVANCED PRACTICE NURSING
Entity Type:Organization
Organization Name:NIGHTINGALE CENTER FOR ADVANCED PRACTICE NURSING
Other - Org Name:THE NIGHTINGALE CENTER FOR PRIMARY CARE AND WOMEN'S HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JESSI
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMANUZZI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:209-214-9430
Mailing Address - Street 1:19526 HILLSDALE DR STE B
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-9234
Mailing Address - Country:US
Mailing Address - Phone:209-214-9430
Mailing Address - Fax:
Practice Address - Street 1:19526C HILLSDALE DR
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-9230
Practice Address - Country:US
Practice Address - Phone:209-214-9430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care