Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Sep 23, 2020
License(s)
APRN11007507 (FL), APRN11007507 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 12902 USF MAGNOLIA DR | Tampa, FL 33612-9416 | 813-745-8380 |
| MAILING | PO BOX 198441 | Atlanta, GA 30384-8441 |
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