Individual
SHARON CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
13391 HENDERSON DR, HAMPTON, GA 30228-3453
(708) 941-6739
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN100226
GA
Other
Enumeration date
03/22/2022
Last updated
03/22/2022
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