Individual
REGINA RENEE BURNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1701 HARDEE AVE, FT MCPHERSON, GA 30330
(404) 464-0242
Mailing address
10107 CAVALIER XING, LITHONIA, GA 30038
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP41523
MD
Other
Enumeration date
05/16/2007
Last updated
07/08/2007
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