Individual
JAKYRA BENTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
207 AUTUMN WOODS DR, WARNER ROBINS, GA 31088-6716
(404) 454-1901
Mailing address
207 AUTUMN WOODS DR, WARNER ROBINS, GA 31088-6716
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN095682
GA
Other
Enumeration date
08/11/2021
Last updated
08/11/2021
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