Individual
LAUREN MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10847 BONNELLY DR, JACKSONVILLE, FL 32218-4850
(904) 802-4547
Mailing address
10847 BONNELLY DR, JACKSONVILLE, FL 32218-4850
(904) 802-4547
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA203080
FL
Other
Enumeration date
04/05/2017
Last updated
07/28/2021
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