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Individual

MRS. EUGENIE GRANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNA/PERS. ASST.

Contact information

Practice address
3112 SW WATSON CT, PORT ST LUCIE, FL 34953-6302
(772) 344-3531
Mailing address
3112 SW WATSON CT, PORT ST LUCIE, FL 34953-6302
(772) 344-3531

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
1232
FL
376K00000X
Nurse's Aide
Primary
1289
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
685174696
FL
Enumeration date
11/08/2010
Last updated
11/08/2010
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