Jesse Tommy Addington, LVN
Licensed Vocational Nurse in Ukiah, CA. Individual provider (NPI-1).
NPI number1306416136
StatusActive
Last updated in NPPESJun 24, 2021
Details
- NPI
- 1306416136
- Entity type
- Individual (NPI-1)
- Name
- Jesse Tommy Addington
- Credential
- LVN
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 24, 2021
- Certification date
- Jun 24, 2021
- Last updated
- Jun 24, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164X00000X | Licensed Vocational Nurse | 698588 | CA | Yes |
Practice location
1120 S Dora StUkiah, CA 95482-6340
Phone 707-472-2600 · Fax 707-472-2714
Mailing address
1120 S Dora StUkiah, CA 95482-6340
Phone 707-472-2600 · Fax 707-472-2714
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All 20 Licensed Vocational Nurse providers in Ukiah · All 1,707 providers in Ukiah
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