Individual
JANICE LAFAYE IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2501 N PATTERSON ST, VALDOSTA, GA 31602-1735
(229) 333-1110
Mailing address
4100 CONWAY CIR, VALDOSTA, GA 31605-4411
(229) 444-4699
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
198786
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
198786
APRN
GA
Enumeration date
08/07/2018
Last updated
08/07/2018
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