Individual
LANISE ALEXIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
371 NW ARCHER AVE, PORT ST LUCIE, FL 34983-1109
(772) 408-0997
Mailing address
371 NW ARCHER AVE, PORT ST LUCIE, FL 34983-1109
(772) 408-0997
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
CNA60774
FL
Other
Enumeration date
08/28/2007
Last updated
08/28/2007
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