NPI 1104592435

Malory Manders Northrup, LPN

Practitioner Licensed Practical Nurse Dublin, GA

Practice location

Address: 1826 Veterans Blvd, Dublin, GA 31021-3620
Phone: (478) 272-1210
Mailing address: 285 Creekside Dr, Vienna, GA 31092-5921

Registered specialties

Licensed Practical Nurse Primary

Nursing Service Providers Taxonomy 164W00000X Licence LPN097369 (GA)

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Registry record

NPI: 1104592435
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Aug 2021
Record last updated: 17 Aug 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.