Provider Demographics
NPI:1245059369
Name:PERSON, DEJION MICHELLE (LPN)
Entity type:Individual
Prefix:MRS
First Name:DEJION
Middle Name:MICHELLE
Last Name:PERSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:DEJION
Other - Middle Name:MICHELLE
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:302 TARVER ST
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30721-3272
Mailing Address - Country:US
Mailing Address - Phone:706-313-5214
Mailing Address - Fax:
Practice Address - Street 1:4083 CLOUD SPRINGS RD
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-8411
Practice Address - Country:US
Practice Address - Phone:855-694-8288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA098212164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse