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General NPI Number Information
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NPI Number | 1811344633
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Entity Type | Organization
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Legal Business Name | LIFELINE CONNECT NURSE CONSULTING4
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Dates
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Enumeration Date | 05/23/2016
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Last Update Date | 05/23/2016
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Provider Practice Location Address
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Address Line | 460 ALLEN ST
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City | WINTER PARK
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State | FL
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Zip | 32789-3402
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Country | US
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Telephone | 407-732-1949
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Fax |
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Provider Business Mailing Address
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Address Line | 460 ALLEN ST
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City | WINTER PARK
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State | FL
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Zip | 32789-3402
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Country | US
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Telephone | 407-732-1949
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CANDANCE MICHELLE LEDBETTER
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Credential | REGISTERED NURSE
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Telephone | 407-732-1949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | FL
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