Individual
GIDGETTA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
12832 NW CENTRAL AVE, BRISTOL, FL 32321-6918
(850) 643-2292
(850) 643-2309
Mailing address
12832 NW CENTRAL AVE, BRISTOL, FL 32321-6918
(850) 643-2292
(850) 643-2309
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN1240931
FL
Other
Enumeration date
06/06/2014
Last updated
06/06/2014
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