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General NPI Number Information
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NPI Number | 1861642423
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Entity Type | Organization
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Legal Business Name | MRS SHEILA MCKENZIE-GARRETT
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Dates
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Enumeration Date | 09/19/2008
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Last Update Date | 09/19/2008
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Provider Practice Location Address
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Address Line | 1670 CLAIRMONT RD
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City | DECATUR
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State | GA
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Zip | 30033-4004
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Country | US
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Telephone | 404-321-6111
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Fax |
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Provider Business Mailing Address
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Address Line | 5311 CAILTIN LN
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City | DOUGLASVILLE
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State | GA
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Zip | 30135
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Country | US
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Telephone | 678-627-3782
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | MRS. SHEILA MAE MCKENZIE-GARRETT
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Credential |
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Telephone | 678-627-3782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number | 286500000X
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License Number State | GA
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