Individual
MRS. MARYANNE MATHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
182 SPARKLEBERRY BLVD S, QUINCY, FL 32351-8868
(850) 556-2303
(850) 627-1992
Mailing address
182 SPARKLEBERRY BLVD S, QUINCY, FL 32351-8868
(850) 556-2303
(850) 627-1992
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5146675
FL
Other
Enumeration date
11/29/2010
Last updated
11/29/2010
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