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General NPI Number Information
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NPI Number | 1346805652
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Entity Type | Individual
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Provider Name | DAWANNA NECOE LAWRENCE-BRIGHTWELL
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Gender | Female
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Dates
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Enumeration Date | 05/02/2019
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Last Update Date | 05/02/2019
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Provider Practice Location Address
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Address Line | 134 HERMAN ST
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City | ATHENS
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State | GA
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Zip | 30601-3000
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Country | US
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Telephone | 770-778-2269
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 315
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City | STATHAM
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State | GA
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Zip | 30666-0006
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Country | US
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Telephone | 770-778-2269
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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