Individual
JANICE CLACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6958 NW HARTNEY WAY, PORT ST LUCIE, FL 34983-1320
(772) 878-3874
Mailing address
6958 NW HARTNEY WAY, PORT ST LUCIE, FL 34983-1320
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 5145291
FL
Other
Enumeration date
10/24/2007
Last updated
10/24/2007
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