Individual
ELYSHIA STOUTAMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
487 ISLAMORADA DR S, MACCLENNY, FL 32063-4222
(904) 235-4630
Mailing address
487 ISLAMORADA DR S, MACCLENNY, FL 32063-4222
(904) 235-4630
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
204621
FL
Other
Enumeration date
08/03/2015
Last updated
08/03/2015
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