Individual
LISA JAMES TAITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
41 TEMPLE DR, SAINT AUGUSTINE, FL 32092-3327
(904) 921-9513
Mailing address
41 TEMPLE DR, SAINT AUGUSTINE, FL 32092-3327
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
346368
NY
Other
Enumeration date
01/07/2025
Last updated
01/07/2025
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