Individual
EDNA ELAINE MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2169 W POINT RD, LAGRANGE, GA 30240-4002
(706) 902-9516
Mailing address
35 ELY CALLAWAY ROAD, WEST POINT, GA 31833
(706) 885-1401
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1-108083
AL
363LF0000X
Family Nurse Practitioner
Primary
RN185828
GA
Other
Enumeration date
09/28/2012
Last updated
10/23/2025
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