Individual
LAKESHA WILSON BURNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
655 7TH ST BLDG 700700A, WARNER ROBINS, GA 31098-2227
(478) 497-1993
Mailing address
203 LOUDON HILL DR, WARNER ROBINS, GA 31088-8531
(478) 550-5789
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
RN148146
GA
363LF0000X
Family Nurse Practitioner
Primary
RN148146
GA
Other
Enumeration date
12/29/2018
Last updated
09/06/2019
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