Individual
TANISHA HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1833 SW CAPEHART AVE, PORT SAINT LUCIE, FL 34953-4606
(772) 240-9417
(772) 673-8228
Mailing address
10380 SW VILLAGE CENTER DR # 188, PORT SAINT LUCIE, FL 34987-1931
(772) 240-9417
(772) 673-8228
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
9481114
FL
251E00000X
Home Health Agency
9481114
FL
3747P1801X
Personal Care Attendant
9481114
FL
385H00000X
Respite Care
9481114
FL
Other
Enumeration date
02/12/2020
Last updated
02/12/2020
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