Individual
DEBRA COOKS BOATMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1062 NE REAGAN RD, MADISON, FL 32340-5541
(850) 973-3839
Mailing address
1062 NE REAGAN RD, MADISON, FL 32340-5541
(850) 973-3839
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5163010
FL
Other
Enumeration date
05/17/2017
Last updated
05/17/2017
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