Provider Demographics
NPI:1730362690
Name:KIENZLE, ALICE JEAN (RN/PHN)
Entity type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:JEAN
Last Name:KIENZLE
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Gender:F
Credentials:RN/PHN
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Mailing Address - Street 1:202 MIRA LOMA DR
Mailing Address - Street 2:NURSING DIVISION
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-3500
Mailing Address - Country:US
Mailing Address - Phone:530-538-7831
Mailing Address - Fax:530-538-7297
Practice Address - Street 1:202 MIRA LOMA DR
Practice Address - Street 2:NURSING DIVISION
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-3500
Practice Address - Country:US
Practice Address - Phone:530-538-7831
Practice Address - Fax:530-538-7297
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
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Provider Licenses
StateLicense IDTaxonomies
CA2893422083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine