Organization
VETERANS AFFAIRS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TEENA LISTON RN (CHIEF NURSE, LC OPERATIONS)
(386) 755-3016
Entity
Organization
Contact information
Practice address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(386) 755-3016
Mailing address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(386) 755-3016
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
RN9247480
FL
Other
Enumeration date
05/11/2016
Last updated
05/11/2016
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