Individual
TATICHIA HALIBURTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1051 CENTER STONE LN, RIVIERA BEACH, FL 33404-1825
(561) 370-8622
Mailing address
1051 CENTER STONE LN, RIVIERA BEACH, FL 33404-1825
(561) 370-8622
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5171716
FL
Other
Enumeration date
04/10/2024
Last updated
04/15/2024
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