Provider Demographics
NPI:1740359538
Name:WITTHUHN, LILIA ROSE (RNP)
Entity type:Individual
Prefix:MRS
First Name:LILIA
Middle Name:ROSE
Last Name:WITTHUHN
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
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Mailing Address - Street 1:4096 GERMAINDER WAY
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2106
Mailing Address - Country:US
Mailing Address - Phone:949-551-3452
Mailing Address - Fax:
Practice Address - Street 1:1725 WEST SEVENTEENTH ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706
Practice Address - Country:US
Practice Address - Phone:714-834-8780
Practice Address - Fax:714-834-8275
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARN410953363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health