LORI ANGELEENE MODLY

GAINESVILLE, GA
NPI1871860692
Former NameLORI ANGELEENE O'SHEA
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0200X Nurse Practitioner, Pediatrics
(Licence: GA  RN201247)
Enumeration Date2011-11-22
Last Update Date2012-02-28
Business Address
-- LORI ANGELEENE MODLY CPNP
743 SPRING ST NE
GAINESVILLE, GA 30501-3715
Phone number: 770-535-3611
Mailing Address
-- LORI ANGELEENE MODLY CPNP
PO BOX 658
GAINESVILLE, GA 30503-0658
Phone number: 770-718-1122