Individual
MRS. SYDNEY RAY CHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
213 BOURMONT RD, ST AUGUSTINE, FL 32095-0068
(206) 310-6301
Mailing address
213 BOURMONT RD, ST AUGUSTINE, FL 32095-0068
(206) 310-6301
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9651980
FL
Other
Enumeration date
10/15/2024
Last updated
10/15/2024
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