Individual
MR. JOHN CHINAKA IBEMERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 966-2483
Mailing address
2535 CROOKED CREEK LN, DECATUR, GA 30035-3020
(404) 966-2483
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN076563
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPN076563
LPN
GA
Enumeration date
06/25/2013
Last updated
06/25/2013
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