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Individual

GEORGETTE HOLLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
415 16TH ST, WEST PALM BEACH, FL 33407-6414
(561) 674-6294
Mailing address
415 16TH ST, WEST PALM BEACH, FL 33407-6414
(561) 674-6294

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
256932
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
639864
FL
Enumeration date
10/11/2016
Last updated
10/11/2016
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