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Individual

TERWKO DEWITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1003 N 18TH ST # B-196, PALATKA, FL 32177-2015
(407) 409-9927
Mailing address
1003 N 18TH ST # B-196, PALATKA, FL 32177-2015
(407) 409-9927

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5243824
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PN5243824
DOH
Enumeration date
02/15/2022
Last updated
02/15/2022
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