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1699010637
ELAINE WICKHAM
LAKELAND, FL
NPI
1699010637
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: FL PN5199622)
Enumeration Date
2012-12-03
Last Update Date
2012-12-03
Business Address
ELAINE WICKHAM
1835 GILMORE AVE
LAKELAND, FL 33805-3017
Phone number: 863-519-0575
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Mailing Address
ELAINE WICKHAM
PO BOX 1559
BARTOW, FL 33831-1559
Phone number:
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