Individual
MS. LESTEENA JOHANA STAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2045 LOWN FARM TRL, LITHONIA, GA 30058-3952
(470) 755-1064
Mailing address
2045 LOWN FARM TRL, LITHONIA, GA 30058-3952
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN157147
GA
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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