Individual
MS. EDNA CAROL STEWARD MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6707 FOREST PARK DR, SAVANNAH, GA 31406-2566
(912) 335-1699
Mailing address
6707 FOREST PARK DR, SAVANNAH, GA 31406-2566
(912) 335-1699
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN076519
GA
Other
Enumeration date
07/16/2018
Last updated
07/16/2018
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