Individual
MR. GASNER JOHN FLEURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
3073 PANTHERSVILLE RD, DECATUR, GA 30034-3828
(404) 212-4790
Mailing address
3964 SUE LN, DECATUR, GA 30035-1069
(404) 288-9802
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN059064
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPN 059064
NURSING
GA
Enumeration date
04/24/2007
Last updated
07/08/2007
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