Individual
MRS. TAWANNA LATOYA ROANE-STILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2109 FAIRBURN RD STE A, DOUGLASVILLE, GA 30135-1037
(770) 726-7958
Mailing address
2109 FAIRBURN RD STE A, DOUGLASVILLE, GA 30135-1037
(770) 726-7958
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN097610
GA
Other
Enumeration date
12/23/2020
Last updated
12/29/2020
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