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Individual

LENORA DIANN WESLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7840 HERRINGTON DRIVE, PENSACOLA, FL 32534
(850) 477-0914
Mailing address
7840 HERRINGTON DRIVE, PENSACOLA, FL 32534
(850) 477-0914

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
141559000
FL
01
6905237
AHCA LICENSE
FL
Enumeration date
02/18/2015
Last updated
02/18/2015
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