Individual
MRS. SHONDA WIMBUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
1474 INTERLAKEN PASS, JONESBORO, GA 30238-6529
(470) 755-5587
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN050255
GA
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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