Provider Demographics
NPI:1245564764
Name:IMRAN, ATHER (LVN)
Entity Type:Individual
Prefix:
First Name:ATHER
Middle Name:
Last Name:IMRAN
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 OAK AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-3840
Mailing Address - Country:US
Mailing Address - Phone:530-666-4606
Mailing Address - Fax:
Practice Address - Street 1:155 OAK AVE APT 10
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3840
Practice Address - Country:US
Practice Address - Phone:530-666-4606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN214526164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse