Individual
BERTINE METAGO LUNDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1255 HIGHWAY 54 W, FAYETTEVILLE, GA 30214-4526
(404) 367-3014
Mailing address
1255 HIGHWAY 54 W, FAYETTEVILLE, GA 30214-4526
(404) 367-3014
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
296527
NY
363L00000X
Nurse Practitioner
Primary
RN245551
GA
Other
Enumeration date
04/07/2009
Last updated
09/19/2022
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