Individual
MARCIA M HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1632 TALON CT, KISSIMMEE, FL 34746-4518
(407) 738-5716
(407) 201-2999
Mailing address
1632 TALON CT, KISSIMMEE, FL 34746-4518
(407) 738-5716
(407) 201-2999
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN1167131
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PN1167131
DOH
GA
Enumeration date
10/06/2017
Last updated
10/06/2017
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