Individual
JAMILA HADIYA MASIKA MCNISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
227 E HILL ST, THOMASVILLE, GA 31792-6134
(229) 379-1136
Mailing address
107 N MLK JR DR, THOMASVILLE, GA 31792-6318
(229) 379-1136
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN080016
GA
Other
Enumeration date
11/23/2021
Last updated
11/23/2021
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