Provider Demographics
NPI:1215181862
Name:GENUS, KAMI (LPN)
Entity Type:Individual
Prefix:
First Name:KAMI
Middle Name:
Last Name:GENUS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9584 WOODSTONE MILL DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-7909
Mailing Address - Country:US
Mailing Address - Phone:904-521-4583
Mailing Address - Fax:904-777-1525
Practice Address - Street 1:9584 WOODSTONE MILL DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-7909
Practice Address - Country:US
Practice Address - Phone:904-521-4583
Practice Address - Fax:904-777-1525
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5175780164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse