Individual
MS. LISA MYRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
810 NW 14TH AVE, FT LAUDERDALE, FL 33311-7045
(954) 226-7920
Mailing address
810 NW 14TH AVE, FT LAUDERDALE, FL 33311-7045
(954) 226-7920
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN1152451
FL
Other
Enumeration date
04/21/2016
Last updated
04/21/2016
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