Individual
MRS. LATONYA MONIQUE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2607 LEDO RD, ALBANY, GA 31707-1211
(229) 903-0022
(229) 903-0025
Mailing address
2607 LEDO RD, ALBANY, GA 31707-1211
(229) 903-0022
(229) 903-0025
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN089401
GA
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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