Individual
MONICA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
310 E BYRD AVE, BONIFAY, FL 32425-3068
(850) 832-8858
Mailing address
1811A PINEY GROVE RD, CHIPLEY, FL 32428-4066
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5151458
FL
Other
Enumeration date
04/23/2019
Last updated
04/23/2019
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