Jalita Lauren Clark, LPN Valid NPI

Individual provider · Licensed Practical Nurse · Columbus, GA

NPI

1790175990

Type

Individual (Type 1)

Primary specialty

Licensed Practical Nurse

Specialty group

Nursing Service Providers

Taxonomy code

164W00000X

License number

LPN070344 (GA)

Sex

Female

Sole proprietor

Yes

Enumerated

2015-01-27

Last updated

2015-01-27