Individual
YASMINE OMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(862) 224-9615
Mailing address
972 ASHTON PARK DR, LAWRENCEVILLE, GA 30045-7278
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN092693
GA
Other
Enumeration date
02/07/2019
Last updated
02/07/2019
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