Individual
STEPHANIE BERROA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2710
Mailing address
1183 IRONWOOD DR, GRAYSON, GA 30017-1039
(203) 509-8764
(678) 212-6304
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
16WOOOOOX
GA
Other
Enumeration date
02/04/2016
Last updated
02/04/2016
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