Individual
LANESHA TEAGUE-DANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
309 GRADY AVE NE, ROME, GA 30161-5544
(706) 766-4121
Mailing address
129 LEAFMORE RD SW, ROME, GA 30165-3812
(706) 766-4121
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN097072
GA
Other
Enumeration date
07/15/2021
Last updated
07/15/2021
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