Individual
LAILANI BAILON MCCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
202 W GORDON ST STE A, VALDOSTA, GA 31601-4565
(229) 474-4101
Mailing address
4285 CONWAY CIR, VALDOSTA, GA 31605-4410
(229) 588-9268
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
138801
GA
Other
Enumeration date
12/04/2024
Last updated
12/06/2024
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