Individual
/MAVIS HNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 S 10TH ST, FORT PIERCE, FL 34950-8516
(772) 332-1326
(772) 460-8498
Mailing address
600 S 10TH ST, FORT PIERCE, FL 34950-8516
(772) 332-1326
(772) 460-8498
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
142620
FL
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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