Individual
LAQUNITA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2126 LEAFMORE CT, GRAYSON, GA 30017-4328
(770) 339-3005
(770) 339-3005
Mailing address
2126 LEAFMORE CT, GRAYSON, GA 30017-4328
(770) 339-3005
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN118830
GA
Other
Enumeration date
08/03/2018
Last updated
08/03/2018
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