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Organization

NURSING DIAGNOSTICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CAROL JEAN DRAKE MSN, RN, CCM (CEO - MANAGER)
(478) 442-3156
Entity
Organization

Contact information

Practice address
312 N DAVIS DR, #100, WARNER ROBINS, GA 31093
(478) 328-7975
Mailing address
404 LAURIE LANE, WARNER ROBINS, GA 31088
(478) 442-3156

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN105510
GA
163WN0800X
Neuroscience Registered Nurse
RN105510
GA
261QR1300X
Rural Health Clinic/Center
RN105510
GA
261QV0200X
VA Clinic/Center
RN105510
GA

Other

Enumeration date
03/27/2018
Last updated
03/27/2018
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