Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | ARNP9226818 | FL |
NPI | 1003352782 |
---|---|
Provider Name | Lindsey Fletcher |
First Address | St Augustine, FL 32092-1841 |
Second Address | Palatka, FL 32177-3810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2017 |
Last Update Date | 18/01/2017 |