Provider Demographics
NPI:1750870119
Name:SIRMANS, CATHY PLAYER (LPN/PRESIDENT)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:PLAYER
Last Name:SIRMANS
Suffix:
Gender:F
Credentials:LPN/PRESIDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54791 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:CALLAHAN
Mailing Address - State:FL
Mailing Address - Zip Code:32011-7615
Mailing Address - Country:US
Mailing Address - Phone:904-316-7290
Mailing Address - Fax:904-879-1607
Practice Address - Street 1:54791 CHURCH RD
Practice Address - Street 2:
Practice Address - City:CALLAHAN
Practice Address - State:FL
Practice Address - Zip Code:32011-7615
Practice Address - Country:US
Practice Address - Phone:904-316-7290
Practice Address - Fax:904-879-1607
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-01
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5149207372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL82-4658962OtherAARP MEDICARECOMPLETE UNITEDHEALTHCARE