Individual
MRS. ADRIENNE DENISE MUBARAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
30 EDGELY LN, PALM COAST, FL 32164-6353
(773) 457-9000
Mailing address
30 EDGELY LN, PALM COAST, FL 32164-6353
(773) 457-9000
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN9378786
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN9378786
FL APRN LICENSE
FL
01
—
RN9378786
FL RN LICENSE
FL
Enumeration date
06/01/2011
Last updated
08/19/2019
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