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1518122563
BRENDA MARIE BLACK
REIDSVILLE, GA
NPI
1518122563
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Former Name
BRENDA MARIE BLACK
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: GA LPN051788)
Enumeration Date
2008-07-18
Last Update Date
2008-07-18
Business Address
Mrs. BRENDA MARIE BLACK LPN
150 MEMORIAL DRIVE 150 MEMORIAL DRIVE
REIDSVILLE, GA 30453
Phone number: 912-557-6794
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Mailing Address
Mrs. BRENDA MARIE BLACK LPN
PO BOX 818 150 MEMORIAL DRIVE
REIDSVILLE, GA 30453-0818
Phone number: 912-557-6794
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