Melissa Renee Rundquist, LVN

Individual provider Active NPI Licensed Vocational Nurse · Calimesa, CA

NPI 1538431069 · NPPES record last updated Jan 30, 2012

Key facts

NPI
1538431069
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
VN213557 (CA)
Practice address
286 Harruby Dr
Calimesa, CA 92320-1630
Phone
(951) 452-2148
NPI assigned
Jan 30, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
VN213557CAMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X VN213557 CA Yes

Addresses

Primary practice location

286 Harruby Dr
Calimesa, CA 92320-1630

Mailing address

286 Harruby Dr
Calimesa, CA 92320-1630
Phone (951) 452-2148

Other providers in Calimesa, CA

All providers in Calimesa, CA · Licensed Vocational Nurse in California

Sources for this page

Verify at the official NPI Registry.