Chanda Agee, LPN
Individual provider Active NPI Licensed Practical Nurse · Fayetteville, GA
NPI 1992257398 · NPPES record last updated Nov 1, 2016
Key facts
- NPI
- 1992257398
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- LPN091514 (GA)
- Practice address
- 160 W Lake Dr
Fayetteville, GA 30214-3239 - Phone
- (404) 432-0519
- NPI assigned
- Nov 1, 2016
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| LPN091514 | GA | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LPN091514 | GA | Yes |
Addresses
Primary practice location
160 W Lake Dr
Fayetteville, GA 30214-3239
Mailing address
160 W Lake Dr
Fayetteville, GA 30214-3239
Other names
- Chanda Macdowall
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All providers in Fayetteville, GA · Licensed Practical Nurse in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.