Jamaiyah J Abdul-Rabb

Individual provider Active NPI Licensed Practical Nurse · Conyers, GA

NPI 1396459368 · NPPES record last updated Jan 13, 2023

Key facts

NPI
1396459368
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
LPN101533 (GA)
Practice address
1774 Morgan LN
Conyers, GA 30012-5571
Phone
(414) 551-5417
NPI assigned
Jan 13, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LPN101533GAMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN101533 GA Yes

Addresses

Primary practice location

1774 Morgan LN
Conyers, GA 30012-5571

Mailing address

1774 Morgan LN
Conyers, GA 30012-5571

Other providers in Conyers, GA

All providers in Conyers, GA · Licensed Practical Nurse in Georgia

Sources for this page

Verify at the official NPI Registry.