Individual
MS. LOUELLA SAMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
105 N FRONT ST, SEAFORD, DE 19973-2707
(302) 536-1952
Mailing address
21630 HACKNEY CIR, LINCOLN, DE 19960-2659
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L2-0012454
DE
Other
Enumeration date
02/02/2022
Last updated
02/02/2022
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