Individual
MRS. LUCILLE TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
RN195568
GA
363LP2300X
Primary Care Nurse Practitioner
Primary
RN195568
GA
Other
Enumeration date
05/19/2018
Last updated
01/17/2024
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