Individual
NICOLE CAROLYN LAFAILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11820 SAGEBRUSH CT, JACKSONVILLE, FL 32218-3647
(850) 533-5626
Mailing address
11820 SAGEBRUSH CT, JACKSONVILLE, FL 32218-3647
(850) 533-5626
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
09/08/2023
Last updated
09/08/2023
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