Provider Demographics
NPI:1871220665
Name:POLLOCK, VERONICA MONIQUE (LPN)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:MONIQUE
Last Name:POLLOCK
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 1:6880 BRYANT RD
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32927-2931
Mailing Address - Country:US
Mailing Address - Phone:321-423-0253
Mailing Address - Fax:
Practice Address - Street 1:6880 BRYANT RD
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32927-2931
Practice Address - Country:US
Practice Address - Phone:321-423-0253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5237607164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse