Individual
JENNA HALOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7392 118TH TER, LARGO, FL 33773-3246
(727) 735-1996
Mailing address
7392 118TH TER, LARGO, FL 33773-3246
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9457461
FL
Other
Enumeration date
05/10/2024
Last updated
05/10/2024
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