Individual
JERI DAWN FALLIN-ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA, MEDICATION ADMI
Contact information
Practice address
5934 PITTI LN, YOUNGSTOWN, FL 32466-1949
(850) 257-1429
Mailing address
PO BOX 261, YOUNGSTOWN, FL 32466-0261
(850) 624-4125
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA122786
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CNA122786
CERTIFIED NURSING ASSISTANT LICENSE NUMBER
FL
Enumeration date
11/01/2022
Last updated
11/01/2022
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