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Individual
MAFOUNA BELLY LAURENT
Active
Individual
MAFOUNA BELLY LAURENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN288572
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29173867
DRIVER LICENSE
PA
01
—
PN288572
PRACTICAL NURSE LICENCE
PA
Enumeration date
11/28/2017
Last updated
11/28/2017
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