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1821628207
LATASHA WILEY
JACKSONVILLE, FL
NPI
1821628207
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
(Licence: FL aprn11005781)
Enumeration Date
2020-01-24
Last Update Date
2020-01-24
Business Address
LATASHA WILEY
11698 ALEXANDRA DR
JACKSONVILLE, FL 32218-8874
Phone number: 904-598-4229
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Mailing Address
LATASHA WILEY
11698 ALEXANDRA DR
JACKSONVILLE, FL 32218-8874
Phone number: 904-598-4229
Copy
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