Individual
CHERYL DENISE BORDENAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5321 WINDING GLEN DR, LITHONIA, GA 30038-2398
(678) 533-8633
Mailing address
5321 WINDING GLEN DR, LITHONIA, GA 30038-2398
(678) 533-8633
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN257907
GA
163WG0000X
General Practice Registered Nurse
RN257907
GA
163WH0200X
Home Health Registered Nurse
RN257907
GA
Other
Enumeration date
06/21/2016
Last updated
06/21/2016
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