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Individual

GENEVA THRASHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
5078 US HIGHWAY 80 W, OPELIKA, AL 36804-1875
(334) 695-1873
Mailing address
5078 US HIGHWAY 80 W, OPELIKA, AL 36804-1875
(334) 695-1873

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2-060805
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2-060805
LPN LICENSE
AL
Enumeration date
12/21/2021
Last updated
12/21/2021
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