Individual
LINDA LEE PROUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3905 GRISSOM PKWY, COCOA, FL 32926-3669
(321) 637-1866
(321) 637-1868
Mailing address
4920 CANGRO ST, COCOA, FL 32926-2227
(321) 639-0929
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
PN1228881
FL
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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