Couillard, Charlene M

Couillard, Charlene M is an individual health care provider with primary practice located at 60 Westminster St N Suite A, Lehigh Acres FL 33936-6518. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Couillard, Charlene M can be contacted via phone (239) 368-1808.

Contact Information

Primary practice address
60 Westminster St N Suite A Lehigh Acres FL 33936-6518
Phone: (239) 368-1808
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9102270 Florida

Profile Details

NPI number 1255329678
LBN Legal business name Couillard, Charlene M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2005
Last updated Apr 14th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255329678 NPPES
Florida MEDICAID 291756400

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