Individual
MS. RHANADA SHANAE WYCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1226 TRICE CEMETERY SPUR, THOMASTON, GA 30286
(706) 647-3094
Mailing address
1226 TRICE CEMETARY SPUR, THOMASTON, GA 30286-6931
(706) 647-3094
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN075491
GA
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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