Individual
KETENA D LOUINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
605 SW INDIAN KEY DR, PORT ST LUCIE, FL 34986-2076
(772) 480-3776
Mailing address
605 SW INDIAN KEY DR, PORT ST LUCIE, FL 34986-2076
(772) 480-3776
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
NP3333312
FL
363LG0600X
Gerontology Nurse Practitioner
Primary
NP3333312
FL
Other
Enumeration date
01/05/2022
Last updated
01/25/2022
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