Individual
LACORSCIA MACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
3210 12TH AVE, COLUMBUS, GA 31904-7811
(706) 587-4436
Mailing address
3210 12TH AVE, COLUMBUS, GA 31904-7811
(706) 587-4436
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0030053979
GA
Other
Enumeration date
07/26/2023
Last updated
07/26/2023
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