Individual
MS. IRENE CHEPTOO SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
580 AMBUR LAKE DR, LAWRENCEVILLE, GA 30043-1405
(205) 243-8725
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN101517
GA
Other
Enumeration date
06/05/2025
Last updated
06/05/2025
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