Individual
EVITA HANAYO RENFROE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
22 COLLINS RUN DR, DALLAS, GA 30157-0207
(770) 344-9607
(770) 344-9607
Mailing address
22 COLLINS RUN DR, DALLAS, GA 30157-0207
(770) 344-9607
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN073238
GA
Other
Enumeration date
06/24/2025
Last updated
09/09/2025
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