Individual
CLOVER BROWN-JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4901 NW EVER RD, PORT ST LUCIE, FL 34983-1316
(772) 785-6160
Mailing address
4901 NW EVER RD, PORT ST LUCIE, FL 34983-1316
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 5150246
FL
Other
Enumeration date
09/27/2007
Last updated
09/27/2007
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