Individual
MARY DEBRA CASTERLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
250 BRAY STREET, ATHENS, GA 30601-2244
(706) 612-6995
Mailing address
1878 KERI LN, WINDER, GA 30680-3256
(774) 230-8770
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
091869
GA
Other
Enumeration date
06/25/2020
Last updated
06/25/2020
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