Provider Demographics
NPI:1689742876
Name:FORRESTER, VERONICA ELIZABETH (LPN)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:ELIZABETH
Last Name:FORRESTER
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 1:4433 LAKE TAHOE CIR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-7853
Mailing Address - Country:US
Mailing Address - Phone:561-688-5893
Mailing Address - Fax:
Practice Address - Street 1:4433 LAKE TAHOE CIR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-7853
Practice Address - Country:US
Practice Address - Phone:561-688-5893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5173026164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPN5173027OtherLPN