Provider Demographics
NPI:1528556347
Name:GURR, IRENE MELINDA (RN)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:MELINDA
Last Name:GURR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 N GURR RD
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95341-8896
Mailing Address - Country:US
Mailing Address - Phone:209-201-1978
Mailing Address - Fax:
Practice Address - Street 1:2140 MERCED ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1721
Practice Address - Country:US
Practice Address - Phone:559-600-2382
Practice Address - Fax:559-475-7866
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95157184163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent