Garry Roger Dormevil, NURSE PRACTITIONER
NPI #1164196457 in La Quinta, California
Provider Information
- NPI Number
- 1164196457
- Entity Type
- Individual
- Name
- Garry Roger Dormevil, NURSE PRACTITIONER
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Nurse Practitioner - Family
- Credential
- NURSE PRACTITIONER
- Enumeration Date
- Aug 2, 2021
- Last Updated
- Apr 7, 2022
Practice Location
- Address
- 79440 CORPORATE CENTER DR STE 100
- City
- La Quinta
- State
- California
- ZIP Code
- 92253-7243
- Phone
- (805) 719-3700
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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