| NPI | 1467113563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURONDA STAPLES Owner 850-771-4723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse |
| Additional Taxonomies | 174H00000X Health Educator |
| Enumeration Date | 2022-01-02 |
| Last Update Date | 2022-01-02 |