Most Relevant Information
Provider Data
| NPI Number: | 1003546136 |
| Provider Name: | MARY ETHRIDGE |
| Entity Type: | Individual |
| Taxonomy Code: | 163WR0006X |
| Specialty: | Registered Nurse |
| License Number: | 9221828 |
Most Important Dates
| Enumeration Date: | 06/13/2022 |
| Last Updated: | 06/13/2022 |
Provider Practice Location
16 CEDAR POINT DR
PALM COAST
FL
321644265
Practice Location Phone/Fax
| Phone: | 8505573016 |
| Fax: |
Provider Mailing Location
16 CEDAR POINT DR
PALM COAST
FL
321644265
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |