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Organization

PROFESSIONAL NURSING SERVICES OF NA, LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. E EDWIN LAVENDER (CEO)
(478) 628-5790
Entity
Organization

Contact information

Practice address
107 JACKSON ST, GORDON, GA 31031-3908
(478) 628-5790
(478) 628-2954
Mailing address
PO BOX 67, GORDON, GA 31031-0067
(478) 628-5790
(478) 628-2954

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
158 R 0001
GA

Other

Enumeration date
11/30/2006
Last updated
08/22/2020
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