Provider Demographics
NPI:1861783433
Name:DRISCOLL, ANN CATHERINE (LVN)
Entity type:Individual
Prefix:MISS
First Name:ANN
Middle Name:CATHERINE
Last Name:DRISCOLL
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 SIERRA BLVD APT 45
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4819
Mailing Address - Country:US
Mailing Address - Phone:916-993-6011
Mailing Address - Fax:
Practice Address - Street 1:2400 SIERRA BLVD APT 45
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4819
Practice Address - Country:US
Practice Address - Phone:916-993-6011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-29
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN232523164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse