Individual
HAFEEZAH BOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1668 CARTER LANDING BLVD, JACKSONVILLE, FL 32221-5623
(609) 225-0845
Mailing address
1668 CARTER LANDING BLVD, JACKSONVILLE, FL 32221-5623
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5249151
FL
164X00000X
Licensed Vocational Nurse
PN5249151
FL
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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