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KIANNA TYMORIA BOONE
Phlebotomy >> Technician, Pathology >> Technologists, Technicians & Other Technical Service ProvidersRegistrant NPI Number: 1063036051
Individual Registrant: KIANNA TYMORIA BOONE
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
608 S LEE ST FITZGERALD, GA 31750-3217 US
Tel: 229-472-2246 Fax: --
Tel: 229-472-2246 Fax: --
Contact information for business:
608 S LEE ST FITZGERALD, GA 31750-3217 US
Tel: 229-472-2246 Fax: --
Tel: 229-472-2246 Fax: --
Registration Information:
NPI: 1063036051
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 246RP1900X | Technologists, Technicians & Other Technical Service Providers Technician, Pathology Phlebotomy | GA | 318-10178 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| ARTICLE OF ORGANIZATION | 20070770 | GA | 01 |
