Individual
CANNELLA A MUTCHERSON-JEFFERIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
278 LASALLE LEFALL DR, QUINCY, FL 32351-5324
(850) 875-7200
(850) 875-7216
Mailing address
278 LASALLE LEFALL DR, QUINCY, FL 32351-5324
(850) 875-7200
(850) 875-7216
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN1856912
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346446895
—
FL
Enumeration date
03/02/2018
Last updated
03/02/2018
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