Provider Demographics
NPI:1770711780
Name:EARLS, LUCINDA KATHRYN (CNA)
Entity type:Individual
Prefix:MS
First Name:LUCINDA
Middle Name:KATHRYN
Last Name:EARLS
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 1:737 TARR AVE SW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32908-7496
Mailing Address - Country:US
Mailing Address - Phone:321-917-6055
Mailing Address - Fax:
Practice Address - Street 1:737 TARR AVE SW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32908-7496
Practice Address - Country:US
Practice Address - Phone:321-917-6055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-29
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372500000X
FL186749372600000X, 374U00000X, 376K00000X
FL13747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide