Unknown Individual – Licensed Practical Nurse, NPI 1093879686
Licensed Practical Nurse
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
428, Canton Road, Cumming, Forsyth County, Georgia, 30040, United States
CUMMING, GA 300402002
Phone: (770) 781-6900
Type: Location
449, West Park Street, Buford, Gwinnett County, Georgia, 30518, United States
BUFORD, GA 305183086
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30040)
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