Individual
AYANNA TENAY HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2277 STONE MOUNTAIN LITHONIA RD, LITHONIA, GA 30058-5252
(770) 484-2600
(770) 484-0155
Mailing address
1043 CARRIAGE TRACE CIR, STONE MOUNTAIN, GA 30087-4661
(770) 484-2600
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN067861
GA
Other
Enumeration date
09/24/2012
Last updated
09/24/2012
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