RAIZZA QUEEN BANIQUED ACODE FNP-BC, NP-C
Individual Provider (NPI-1)
Active
Nurse Practitioner
Provider Information
- NPI Number
1245052018- Provider Type
- Individual Provider (NPI-1)
- Credentials
- FNP-BC, NP-C
- Status
- Active
Contact & Location
- Address
- 11633 VICTORY BLVD STE 100, NORTH HOLLYWOOD, CA, 916063513
- Phone
- (888) 530-4415
- Fax
- (833) 471-5322
Specialties & Taxonomies
Nurse Practitioner
Primary License: CA #95032745