Individual
SUNDAE HERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N
Contact information
Practice address
305 NW BROOK LOOP, LAKE CITY, FL 32055-5096
(386) 365-3637
Mailing address
305 NW BROOK LOOP, LAKE CITY, FL 32055-5096
(386) 365-3637
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN3174212
FL
Other
Enumeration date
12/24/2013
Last updated
12/24/2013
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