Individual
LARA LEIGH WINDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
514 W MAPLE ST STE 1206, CUMMING, GA 30040-2536
(770) 844-7826
Mailing address
514 W MAPLE ST STE 1206, CUMMING, GA 30040-2536
(770) 844-7826
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN090617
GA
Other
Enumeration date
04/26/2025
Last updated
04/26/2025
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