Individual
MRS. ATHENA MARIE EIRIKSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
211 W 15TH ST, PANAMA CITY, FL 32401-2230
(850) 769-6001
Mailing address
979 MAYO TRL, CRESTVIEW, FL 32536-5142
(850) 400-0412
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5200778
FL
Other
Enumeration date
09/27/2013
Last updated
10/14/2013
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