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Organization

EQUISENTIAL PRIMARY HEALTHCARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CLAUDETTE JOHNSTON-CREARY APRN (OWNER)
(772) 342-3794
Entity
Organization

Contact information

Practice address
2637 SW IMPORT DR, PORT ST LUCIE, FL 34987-2056
(772) 342-3794
(772) 365-0456
Mailing address
2637 SW IMPORT DR, PORT ST LUCIE, FL 34987-2056
(772) 342-3794
(772) 365-0456

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Enumeration date
10/10/2019
Last updated
05/08/2020
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