Individual
WINSOME P DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
414 44TH ST, WEST PALM BEACH, FL 33407-3853
(561) 385-7140
Mailing address
4501 N FLAGLER DR, WEST PALM BEACH, FL 33407-3837
(561) 385-7140
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5196106
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PN5196106
LPN LICENSE
FL
Enumeration date
05/01/2022
Last updated
05/01/2022
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