Individual
MRS. CLAUDETTE M MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
92 W LOWDER ST, MACCLENNY, FL 32063-2676
(904) 259-0092
(904) 259-0094
Mailing address
92 W LOWDER ST, MACCLENNY, FL 32063-2676
(904) 259-0092
(904) 259-0094
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN3174462
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
770015600
—
FL
Enumeration date
02/16/2006
Last updated
08/01/2023
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