Doctor Name: | JAYME LYNN STORMS |
NPI Number: | 1083078547 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | N.P. |
License Number: | 95003801 |
Business Practice Address: | 718 S 4th St El Centro, CA - 922433319 |
Business Phone Number: | 7603378500 |
Business Fax Number: | 7603378572 |
Mailing Address: | 718 S 4th St, EL CENTRO |
State: | CA |
Postal Code: | 922433319 |
Phone Number: | 7603378500 |
Fax Number: | 7603378572 |
NPI Enumeration Date: | 04/11/2016 |
NPI Last Update Date: | 04/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 95003801 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |