Individual
MRS. LORI W GROGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
123 N 18TH ST, GRIFFIN, GA 30223-2264
(770) 229-1437
Mailing address
123 N 18TH ST, GRIFFIN, GA 30223-2264
(770) 229-1437
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN183551
GA
Other
Enumeration date
12/03/2017
Last updated
12/03/2017
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