Individual
LORTATIA MARSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
1212 MCCOY CHURCH RD, WAYNESBORO, GA 30830-5927
(706) 526-2173
Mailing address
1212 MCCOY CHURCH RD, WAYNESBORO, GA 30830-5927
(706) 526-2173
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
CN0030087992
GA
376K00000X
Nurse's Aide
Primary
CN0030087992
GA
Other
Enumeration date
12/08/2023
Last updated
12/08/2023
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