Provider Demographics
NPI:1487919569
Name:ARMSTRONG, ANNETTE IRENE (LVN)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:IRENE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:MRS
Other - First Name:ANNETTE
Other - Middle Name:IRENE
Other - Last Name:ARMSTRONG-BREWSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:PO BOX 528
Mailing Address - Street 2:
Mailing Address - City:SUTTER
Mailing Address - State:CA
Mailing Address - Zip Code:95982-0528
Mailing Address - Country:US
Mailing Address - Phone:530-844-1747
Mailing Address - Fax:
Practice Address - Street 1:8388 MARSHALL STREET
Practice Address - Street 2:NO MAIL RECEPTACLE/PLEASE USE PO BOX FOR SAFE DELIVERY
Practice Address - City:SUTTER
Practice Address - State:CA
Practice Address - Zip Code:95982
Practice Address - Country:US
Practice Address - Phone:530-674-7665
Practice Address - Fax:530-674-7665
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN157409164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAVN157409OtherLICENSED VOCATIONAL NURSE/BVNPT BOARD ISSUED LICENSE NUMBER