Individual
JACQUELINE DUNNOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1007 MARY ST, WAYCROSS, GA 31503-3823
(912) 449-8601
Mailing address
1007 MARY ST, WAYCROSS, GA 31503-3823
(912) 449-8601
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN055115
GA
Other
Enumeration date
08/21/2009
Last updated
08/21/2009
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