Individual
TISHARA BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
8 PINE BRANCH PL, PALM COAST, FL 32164-4830
(904) 392-1066
Mailing address
8 PINE BRANCH PL, PALM COAST, FL 32164-4830
(904) 392-1066
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
5242698
FL
246RP1900X
Phlebotomy Technician
F8J3R2G2
FL
376K00000X
Nurse's Aide
259957
FL
Other
Enumeration date
10/28/2022
Last updated
10/28/2022
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