Individual
TAWANIA HOLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2647 CHEROKEE AVE, FORT PIERCE, FL 34946-6659
(772) 466-0286
Mailing address
2647 CHEROKEE AVE, FORT PIERCE, FL 34946-6659
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA109742
FL
Other
Enumeration date
06/19/2007
Last updated
07/08/2007
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