Individual
BERNICE ELLIS-VEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2238 NANTUCKET CT NE, MARIETTA, GA 30066-2128
(706) 223-7800
Mailing address
2238 NANTUCKET CT NE, MARIETTA, GA 30066-2128
(706) 223-7800
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN087320
GA
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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