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Individual

PAIGE LYNN PRATHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN, LMT

Contact information

Practice address
5225 7TH ST W, LEHIGH ACRES, FL 33971-1034
(239) 321-2989
Mailing address
5225 7TH ST W, LEHIGH ACRES, FL 33971-1034
(239) 321-2989

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5249933
FL
172M00000X
Mechanotherapist
MA82606
FL
225700000X
Massage Therapist
MA82606
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA82606
FLORIDA BOARD OF MASSAGE
FL
01
PN5249933
FLORIDA BOARD OF NURSING
FL
Enumeration date
08/29/2017
Last updated
07/20/2021
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