Individual
MIA NICOLE MCCANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
348 W HIGHLAND DR, LAKELAND, FL 33813-1543
(863) 608-7778
Mailing address
348 W HIGHLAND DR, LAKELAND, FL 33813-1543
(863) 608-7778
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5263801
FL
Other
Enumeration date
04/27/2026
Last updated
04/27/2026
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