Individual
ANNAMMA VARGHESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
138 SHANNON OAKS DR, LAKELAND, FL 33813-5664
(407) 334-6328
Mailing address
138 SHANNON OAKS DR, LAKELAND, FL 33813-5664
(407) 334-6328
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5190201
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PN 5190201
LPN LICENSE
FL
Enumeration date
04/22/2010
Last updated
04/22/2010
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