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Individual

ALESHA PATTON PRIDGEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1367 S RAILROAD AVE STE A, CHIPLEY, FL 32428-1461
(850) 676-4273
(850) 676-4274
Mailing address
1367 S RAILROAD AVE STE A, CHIPLEY, FL 32428-1461
(850) 676-4273
(850) 676-4274

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
234778
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
020758200
FL
Enumeration date
07/05/2017
Last updated
07/21/2022
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