Provider Demographics
NPI:1629839295
Name:REMMERS-MESMAN, SHIRLEY ANTOINETTE (NP)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:ANTOINETTE
Last Name:REMMERS-MESMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12571 SCANDIA ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92845-2946
Mailing Address - Country:US
Mailing Address - Phone:714-658-9396
Mailing Address - Fax:
Practice Address - Street 1:12571 SCANDIA ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845-2946
Practice Address - Country:US
Practice Address - Phone:714-658-9396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028444363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health