Individual
LAURA LYNETTE MERRITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AA / B.A
Contact information
Practice address
6165 HYDE PARK LN, LITHONIA, GA 30058-7976
(678) 927-7453
Mailing address
6165 HYDE PARK LN, LITHONIA, GA 30058-7976
(678) 927-7453
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
1236592
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83-1007523
—
GA
05
—
831007523
—
GA
Enumeration date
01/28/2020
Last updated
01/28/2020
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