Individual
MS. ROSEANNA LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3350 EBENEZER RD SE, CONYERS, GA 30094-3404
(000) 000-0000
Mailing address
3974 ANNISTOWN RD APT 801, SNELLVILLE, GA 30039-8472
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
TEMP202439
GA
Other
Enumeration date
08/13/2021
Last updated
08/13/2021
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