Individual
ANTRONETTE DARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1578 CHERRY HILL RD SW, CONYERS, GA 30094-6835
(716) 465-1797
Mailing address
1578 CHERRY HILL RD SW, CONYERS, GA 30094-6835
(716) 465-1797
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN084209
GA
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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