Individual
KIANA ANN CAVIN I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3131 S MAIN ST, MOULTRIE, GA 31768-6925
(229) 529-5402
Mailing address
54 PINE VALLEY CIR, MOULTRIE, GA 31768-5893
(229) 529-5402
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN100675
GA
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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