Individual
MRS. OLIVIA BOATRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
612 CANNING DR, WEWAHITCHKA, FL 32465-4710
(850) 639-2274
(850) 639-2274
Mailing address
612 CANNING DR, WEWAHITCHKA, FL 32465-4710
(850) 639-2274
(850) 639-2274
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN515608
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
230628000
—
FL
Enumeration date
05/28/2008
Last updated
05/28/2008
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