Individual
MARIAH TIENNA PREVATTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1324 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4543
(863) 687-1100
Mailing address
1850 SADDLEWOOD PL, BARTOW, FL 33830-2917
(863) 253-9839
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
RN9423564
FL
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
APRN11035770
FL
Other
Enumeration date
05/20/2024
Last updated
02/09/2025
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