Individual
LASHAVIA PERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2937 GRAVITT TRL, DULUTH, GA 30096-6915
(770) 826-0361
Mailing address
2937 GRAVITT TRL, DULUTH, GA 30096-6915
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN254820
GA
Other
Enumeration date
10/14/2022
Last updated
10/14/2022
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