Facts
- Status
- A
- Credential
- APRN
- Type
- Individual
- Enumeration date
- 2022-03-30
- Last updated
- 2022-04-03
Specialties
Licenses
- License FL
- APRN11018943
Location
- Practice location
- 315 E ASH ST
- City
- PERRY FL
- Postal code
- 323472029
- Phone
- 850-584-3278
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.