Individual
JASMINE LASHEA INGRAM-LUSANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3920 ARKWRIGHT RD STE 140, MACON, GA 31210-1771
(832) 300-0401
Mailing address
358 CYPRESS DR, GRAY, GA 31032-5896
(478) 414-0569
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN209551
GA
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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