Provider Demographics
NPI:1972113850
Name:CANGE, PAULLETTE (CNA)
Entity Type:Individual
Prefix:
First Name:PAULLETTE
Middle Name:
Last Name:CANGE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5860 WESTFALL RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-6731
Mailing Address - Country:US
Mailing Address - Phone:954-822-1230
Mailing Address - Fax:
Practice Address - Street 1:5860 WESTFALL RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-6731
Practice Address - Country:US
Practice Address - Phone:954-822-1230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA39423376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide