Provider Demographics
NPI:1396639142
Name:FOLDS, LORETTA LYN
Entity type:Individual
Prefix:
First Name:LORETTA
Middle Name:LYN
Last Name:FOLDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 REED RD
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:31833-4564
Mailing Address - Country:US
Mailing Address - Phone:706-302-0908
Mailing Address - Fax:
Practice Address - Street 1:215 REED RD
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:GA
Practice Address - Zip Code:31833-4564
Practice Address - Country:US
Practice Address - Phone:706-302-0908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN078108164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty