Individual
JOHN S LILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
123 BAPTIST WAY, PENSACOLA, FL 32503-2254
(448) 227-3351
Mailing address
700 N M ST, PENSACOLA, FL 32501-2735
(850) 375-1383
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9550516
FL
Other
Enumeration date
11/28/2024
Last updated
11/28/2024
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