Most Relevant Information
Provider Data
| NPI Number: | 1003310954 |
| Provider Name: | IIESKA SHUNATEL PACKARD LVN |
| Entity Type: | Individual |
| Taxonomy Code: | 164X00000X |
| Specialty: | Licensed Vocational Nurse |
| License Number: | 691498 |
Most Important Dates
| Enumeration Date: | 03/23/2018 |
| Last Updated: | 10/14/2020 |
Provider Practice Location
4441 E KINGS CANYON RD
FRESNO
CA
937023604
Practice Location Phone/Fax
| Phone: | 5596009180 |
| Fax: |
Provider Mailing Location
4441 E KINGS CANYON RD
FRESNO
CA
937023604
Provider Mailing Phone/Fax
| Phone: | 5596009171 |
| Fax: |