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Individual

LOIS ELAINE THORNTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
410 DARLING AVE, WAYCROSS, GA 31501-5246
(912) 338-6438
Mailing address
6228 PALMETTO WAY, BLACKSHEAR, GA 31516-9310
(912) 283-3671

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN104839
GA

Other

Enumeration date
09/01/2010
Last updated
09/01/2010
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