Individual provider · NPI-1
Paris Gilbert Russ Kenzo Aaron
Nurse Practitioner, Family · Sacramento, CA
NPI number1871079111
StatusActive
Last updated in NPPESDec 29, 2023
Details
- NPI
- 1871079111
- Entity type
- Individual (NPI-1)
- Name
- Paris Gilbert Russ Kenzo Aaron
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 18, 2018
- Certification date
- Dec 29, 2023
- Last updated
- Dec 29, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 735782 | CA | Yes |
| 363LF0000X | Nurse Practitioner, Family | ARNP9283795 | FL |
Practice location
4241 Florin RdSacramento, CA 95823-2535
Phone 916-469-4690
Mailing address
12619 Ashley Melisse BlvdJacksonville, FL 32225-5772
Phone 904-705-7208
Other practice locations
12619 Ashley Melisse Blvd
Jacksonville, FL 32225-5772
Jacksonville, FL 32225-5772
Phone 904-705-7208
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