Individual
PAULA RENEE TABOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.N.A.
Contact information
Practice address
115 E MAIN ST STE A1B, BUFORD, GA 30518-5727
(470) 642-2665
Mailing address
115 E MAIN ST # 104, BUFORD, GA 30518-5727
(470) 642-2665
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
21271595
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN0028857742
NURSING AIDE
GA
Enumeration date
01/26/2022
Last updated
01/26/2022
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