Individual
KATHERINE ELAINE CANCEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
802 W DR MARTIN LUTHER KING JR BLVD STE D, PLANT CITY, FL 33563-5105
(727) 754-1496
(813) 754-2553
Mailing address
802 W DR MARTIN LUTHER KING JR BLVD STE D, PLANT CITY, FL 33563-5105
(727) 754-1496
(813) 754-2553
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11000097
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C524-505-87-771-1
FLORIDA DEPARTMENT OF DRIVERS LICENSE
FL
Enumeration date
12/10/2018
Last updated
12/11/2018
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