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General NPI Number Information
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NPI Number | 1225616618
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Entity Type | Organization
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Legal Business Name | BUILD AND RESTORE, LLC
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Dates
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Enumeration Date | 03/29/2021
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 2211 BARTOW ST
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City | BRUNSWICK
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State | GA
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Zip | 31520-5604
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Country | US
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Telephone | 850-210-2473
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Fax |
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Provider Business Mailing Address
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Address Line | 2211 BARTOW ST
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City | BRUNSWICK
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State | GA
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Zip | 31520-5604
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Country | US
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Telephone | 912-254-7672
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Fax |
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Authorized Official
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Title or Position | OWNER/NURSE PRACTITIONER
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Name | MRS. GWENDOLYN FLONNERY-ROBERTS
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Credential | MSN, APRN, FNP-C
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Telephone | 912-209-5444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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