Individual
MARY FLORIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
DEPARTMENT OF VETERAN AFFIARS, 212 WILLOW VALLEY LAKES DRIVE, WILLOW STREET, PA 17584
(484) 740-4434
Mailing address
3428 EISENHOWER AVE, READING, PA 19605-1547
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN240874L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UNKNOWN
OPTIONAL
—
Enumeration date
03/05/2019
Last updated
03/05/2019
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