Individual
SHEQUILA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
14091 SUMMER BREEZE DR E, JACKSONVILLE, FL 32218-8913
(804) 502-5840
(904) 485-8541
Mailing address
1306 MARK CT, APOPKA, FL 32703-6939
(407) 797-2435
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5218517
FL
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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