Individual
KELLY CHRISTINE WOMBLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1602 OAKFIELD DR STE 205, BRANDON, FL 33511-0827
(239) 690-6906
Mailing address
PO BOX 92838, LAKELAND, FL 33804-2838
(863) 602-3797
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11028684
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APRN11028684
FL
Other
Enumeration date
10/10/2023
Last updated
10/14/2024
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