Individual
JENNA LEE LAFTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1000 COMMERCE PARK DR STE 110, WILLIAMSPORT, PA 17701-5475
(570) 323-6944
Mailing address
320 HIGHLAND DR, MOUNTVILLE, PA 17554-1232
(717) 285-7121
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN309082
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PN309082
STATE LICENSE NUMBER
PA
Enumeration date
07/12/2022
Last updated
07/12/2022
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