Individual
WENDY ANN WASSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
2104 MASSEY AVE, NAVAL STATION MAYPORT, MAYPORT, FL 32227
(904) 270-4205
(904) 270-4454
Mailing address
12590 BLUE LAGOON TRL, JACKSONVILLE, FL 32225-5223
(904) 982-9740
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
140103449279957
FL
247200000X
Other Technician
140103449279957
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140103449279957
CERTIFIED PHARMACY TECHNICIAN
—
Enumeration date
03/17/2009
Last updated
03/17/2009
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