MEDICARE: MRS. LETERRIA ENGLISH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	CNA243440	FL
2	376K00000X	Nurse's Aide	243440	FL
3	376J00000X	Homemaker	L18000014110	FL

General Provider Information

NPI Number	:	1275108185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LETERRIA ENGLISH

Provider Business Mailing Address
First Line	:	731 DUVAL STATION RD STE 107-20
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-0800
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	731 DUVAL STATION RD STE 107-20
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-0800
Country	:	US
Telephone Number	:	904-570-8791
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2021
Last Update Date	:	05/24/2021

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Directions to “ MRS. LETERRIA ENGLISH ” Practice Location

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