Individual
KEONDRA COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1350 WALTON WAY, AUGUSTA, GA 30901-2612
(706) 774-2361
Mailing address
2712 SPIRIT CREEK RD, HEPHZIBAH, GA 30815-5993
(706) 495-5841
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN234565
GA
Other
Enumeration date
10/29/2015
Last updated
10/29/2015
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