Provider Demographics
NPI:1407601446
Name:WOUND & MEDICAL PROCEDURES ON-CALL N ECHEVERRIA NP PC
Entity type:Organization
Organization Name:WOUND & MEDICAL PROCEDURES ON-CALL N ECHEVERRIA NP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:NOEMI
Authorized Official - Middle Name:
Authorized Official - Last Name:ECHEVERRIA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:818-939-3548
Mailing Address - Street 1:6625 NESTLE AVE
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-5515
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:818-301-2023
Practice Address - Street 1:6625 NESTLE AVE
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-5515
Practice Address - Country:US
Practice Address - Phone:818-939-3548
Practice Address - Fax:818-301-2023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-23
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty