Individual
MS. PORTIA RAMONA DEBREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
125 BRAMBLE WAY, GRIFFIN, GA 30224-5445
(678) 670-6209
Mailing address
125 BRAMBLE WAY, GRIFFIN, GA 30224-5445
(678) 670-6209
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN083753
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPN083753
LICENSE PRACTICAL NURSE
GA
Enumeration date
10/27/2014
Last updated
10/27/2014
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