Individual
STEPHANIE HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1853 SW RENFRO ST, PORT ST LUCIE, FL 34953-1375
(772) 621-9468
Mailing address
1853 SW RENFRO ST, PORT ST LUCIE, FL 34953-1375
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA 16128
FL
Other
Enumeration date
07/19/2007
Last updated
07/19/2007
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