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Individual

MRS. DEANNA EDWARDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN095757

Contact information

Practice address
159 SPRING ST, FAIRMOUNT, GA 30139-3248
(706) 676-1480
Mailing address
159 SPRING ST, FAIRMOUNT, GA 30139-3248
(706) 676-1480

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN095757
GA

Other

Enumeration date
02/08/2024
Last updated
02/08/2024
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