Individual
MRS. NORDWANNA VENITE-LUBIN HYSONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPM
Contact information
Practice address
7387 MALENTA CT APT C, FORT STEWART, GA 31315-1243
(941) 467-5803
Mailing address
7387 MALENTA CT APT C, FORT STEWART, GA 31315-1243
(941) 467-5803
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
164W00000X
Licensed Practical Nurse
LPN094918
GA
Other
Enumeration date
11/29/2018
Last updated
11/29/2018
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