MEDICARE: MS. MICHELLE JOANNE DRUMM-WILLIAMS LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	LPN052801	GA

General Provider Information

NPI Number	:	1033283635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE JOANNE DRUMM-WILLIAMS LPN

Provider Business Mailing Address
First Line	:	576 BLUEBIRD TRL
Second Line	:
City	:	FORTSON
State	:	GA
Zip	:	31808-7011
Country	:	US
Telephone Number	:	706-566-2538
Fax Number	:

Provider Business Practice Location Address
First Line	:	BLDG 9244, MARTIN LOOP
Second Line	:
City	:	FORT BENNING
State	:	GA
Zip	:	31905
Country	:	US
Telephone Number	:	706-544-2633
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	07/08/2007

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