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1316416076
LISA TRACY ANN BRYAN UKAWUILULU
DAYTONA BEACH, FL
NPI
1316416076
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: FL 9282094)
Enumeration Date
2018-11-23
Last Update Date
2018-11-23
Business Address
LISA TRACY ANN BRYAN UKAWUILULU APRN
405 N CLYDE MORRIS BLVD
DAYTONA BEACH, FL 32114-2730
Phone number: 386-506-8555
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Mailing Address
LISA TRACY ANN BRYAN UKAWUILULU APRN
5418 FAN PALM CT
PORT ORANGE, FL 32128-7447
Phone number: 386-214-5004
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