Basic Information
| Provider Information | |||||||||
| NPI: | 1083934855 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JESRANI | ||||||||
| FirstName: | LENA | ||||||||
| MiddleName: | BHARAT | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MSN, FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2450 SISTER MARY COLUMBA DR | ||||||||
| Address2: | |||||||||
| City: | RED BLUFF | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960804356 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5305270414 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 20833 LONG BRANCH DR | ||||||||
| Address2: | |||||||||
| City: | COTTONWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960228701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5305270414 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2010 | ||||||||
| LastUpdateDate: | 04/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 19382 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | NP19382 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.