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Individual

CIERRA ELIZABETH CARTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
906 W MONROE ST APT 401, JACKSONVILLE, FL 32204-1184
(904) 382-8944
Mailing address
2020 W 6TH ST, JACKSONVILLE, FL 32209-5871
(904) 382-8944

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5239907
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5239907
FL
Enumeration date
06/25/2019
Last updated
06/25/2019
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