Individual
LA RAVEN RAMBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
95 HOWELL DR SW, ATLANTA, GA 30331-4020
(404) 449-8544
(404) 478-9976
Mailing address
PO BOX 92141, ATLANTA, GA 30314-0141
(404) 449-8544
(404) 478-9976
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN076753
GA
Other
Enumeration date
02/22/2017
Last updated
02/22/2017
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