Mary Ethridge
Registered Nurse, Registered Nurse First Assistant in Palm Coast, FL. Individual provider (NPI-1).
NPI number1003546136
StatusActive
Last updated in NPPESJun 13, 2022
Details
- NPI
- 1003546136
- Entity type
- Individual (NPI-1)
- Name
- Mary Ethridge
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 13, 2022
- Certification date
- Jun 13, 2022
- Last updated
- Jun 13, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WR0006X | Registered Nurse, Registered Nurse First Assistant | 9221828 | FL | Yes |
Practice location
16 Cedar Point DrPalm Coast, FL 32164-4265
Phone 850-557-3016
Mailing address
16 Cedar Point DrPalm Coast, FL 32164-4265
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