Individual
MRS. MYISHA GADDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN-RETIRED
Contact information
Practice address
6459 HIGHWAY 42, REX, GA 30273-1718
(678) 973-5257
Mailing address
PO BOX 1, HAMPTON, GA 30228-0001
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
83495
NC
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
12/01/2021
Last updated
12/01/2021
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