Individual
MS. KENISHA ERRONDA STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 596-5737
Mailing address
9040 SANTE FE CT, COLUMBUS, GA 31909-6036
(706) 940-8453
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN069350
GA
Other
Enumeration date
07/22/2014
Last updated
10/20/2020
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