Provider Demographics
NPI:1558995456
Name:VU, JUWLERY (RN, CPN, NP-C)
Entity Type:Individual
Prefix:
First Name:JUWLERY
Middle Name:
Last Name:VU
Suffix:
Gender:F
Credentials:RN, CPN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 HARBOR BLVD STE B210
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-5890
Mailing Address - Country:US
Mailing Address - Phone:949-548-2273
Mailing Address - Fax:
Practice Address - Street 1:2200 HARBOR BLVD STE B210
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-5890
Practice Address - Country:US
Practice Address - Phone:949-548-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-28
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95012182363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily