Individual
REBECCA HEATHERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1501 GEORGIA AVE, WOODBINE, GA 31569-5504
(912) 576-3040
(912) 576-3833
Mailing address
150 SCRANTON CONNECTOR, BRUNSWICK, GA 31525-0540
(912) 280-1462
(912) 262-3036
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
80366
GA
Other
Enumeration date
07/30/2012
Last updated
07/30/2012
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