Individual
LAVERNE J ENRIQUE-LOFTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
690 REDDS CIR SW, LILBURN, GA 30047-6525
(404) 534-0035
Mailing address
3110 CLIFTON SPRINGS RD, DECATUR, GA 30034-4600
(678) 223-8287
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
RN111252
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
667281594A
—
GA
Enumeration date
02/21/2006
Last updated
08/23/2016
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