Provider Demographics
NPI:1164680740
Name:GIVENS, JULIET S (LPN)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:S
Last Name:GIVENS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 COUNTRY WALK DR
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-8724
Mailing Address - Country:US
Mailing Address - Phone:912-764-6906
Mailing Address - Fax:912-489-4470
Practice Address - Street 1:4 W ALTMAN ST
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-5277
Practice Address - Country:US
Practice Address - Phone:912-764-6906
Practice Address - Fax:912-489-4470
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN033692164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse