Individual
DANA RENEE SARGENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
32325 GRAND PARKE BLVD, FERNANDINA BEACH, FL 32034-1131
(904) 261-0429
(904) 733-2650
Mailing address
32325 GRAND PARKE BLVD, FERNANDINA BEACH, FL 32034-1131
(904) 261-0429
(904) 733-2650
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5167063
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HCBS 693 327 196
—
FL
Enumeration date
08/18/2008
Last updated
08/18/2008
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