| Doctor Name: | MS. ANNE C RETALLICK |
| NPI Number: | 1144315730 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 358288 10493 |
| Business Practice Address: | 1 Madrone St Frank Howard Memorial Hospital Willits, CA - 954904225 |
| Business Phone Number: | 7074596801 |
| Business Fax Number: | |
| Mailing Address: | 422 South Barnes Street, UKIAH |
| State: | CA |
| Postal Code: | 95482 |
| Phone Number: | 7074625861 |
| Fax Number: | |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0000X |
| License Number: | 358288 10493 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | General Practice |
| Taxonomy Definition: | |