Individual
LAUREN ASHLEY POTTER-KITCHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4075 SUNRISE FARMS RD, MIDDLEBURG, FL 32068-3780
(904) 509-4861
Mailing address
4075 SUNRISE FARMS RD, MIDDLEBURG, FL 32068-3780
(904) 509-4861
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
015319300
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015319300
—
FL
Enumeration date
01/08/2019
Last updated
01/08/2019
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