Individual
KERA DEGRANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
419 SE 21ST LN, CAPE CORAL, FL 33990-4370
(754) 265-6534
Mailing address
13031 QUAIL CT, ORLANDO, FL 32828-9070
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11002957
FL
Other
Enumeration date
10/09/2020
Last updated
10/14/2020
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