Individual
MS. HOLLY LAVENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1016 KEITH DR, PERRY, GA 31069
(478) 988-1515
(478) 988-1550
Mailing address
1016 KEITH DR, PERRY, GA 31069
(478) 988-1515
(478) 988-1550
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN184680
GA
Other
Enumeration date
01/07/2016
Last updated
01/07/2016
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