MEDICARE: MRS. CHERYL LAVONNE BRIGGS RN

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	163W00000X	Registered Nurse	RN059401	GA

General Provider Information

NPI Number	:	1467469619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERYL LAVONNE BRIGGS RN

Provider Business Mailing Address
First Line	:	3510 SLEEPING FAWN KNLS
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30034-4892
Country	:	US
Telephone Number	:	404-241-1639
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 LAKEWOOD WAY SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30315-6022
Country	:	US
Telephone Number	:	404-762-3650
Fax Number	:	404-624-0638

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/08/2007

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