Individual
WANDA SUE MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4234 SUNNILAND ST, SARASOTA, FL 34233-1817
(941) 921-3801
Mailing address
4234 SUNNILAND ST, SARASOTA, FL 34233-1817
(941) 921-3801
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
8267
FL
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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