Organization
IN HOME PRIMARY CARE PROVIDER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRIS C BRACKEN NP (OWNER)
(813) 406-1925
Entity
Organization
Contact information
Practice address
5545 MARIE DR, ZEPHYRHILLS, FL 33541-1913
(813) 406-1925
Mailing address
5545 MARIE DR, ZEPHYRHILLS, FL 33541-1913
(813) 406-1925
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2078202
FL
Other
Enumeration date
12/02/2010
Last updated
12/02/2010
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