Individual
DENNISE BONNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7569 PINE LAKES BLVD, PORT ST LUCIE, FL 34952-1510
(772) 340-7531
Mailing address
7569 PINE LAKES BLVD, PORT ST LUCIE, FL 34952-1510
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 1256191
FL
Other
Enumeration date
04/06/2007
Last updated
07/08/2007
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