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Individual

JACQUELINE M. LA MANNA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
2275 S. BABCOCK ST., MELBOURNE, FL 32901-5305
(321) 726-2925
(321) 984-4825
Mailing address
2575 N. COURTENAY PKWY, MERRITT ISLAND, FL 32953
(321) 454-7148
(321) 449-5015

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
363L00000X
Nurse Practitioner
Primary
ARNP1636342
FL

Other

Enumeration date
05/13/2014
Last updated
05/13/2014
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