Malory Manders Northrup, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN097369 Issued in GA

Practice address

1826 Veterans Blvd
Dublin, GA 31021-3620

Phone

(478) 272-1210

NPI assigned

Aug 17, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1104592435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 CREEKSIDE DR",
            "city": "VIENNA",
            "state": "GA",
            "postal_code": "310925921",
            "telephone_number": "229-322-8752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 VETERANS BLVD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310213620",
            "telephone_number": "478-272-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHRUP",
        "first_name": "MALORY",
        "middle_name": "MANDERS",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN097369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonya B Nicholson, C.N.M.
• Grace Ninan, PHARMD
• Lilian C Nnamuchi, MD
• Roy Douglas Noll
• Charles Richard Noplis Sr., RPH
• Sheila Ann Nulf, RN
• Stacey O'Neal, PT, DPT
• Oatts Drug Company Inc
• Sheneka Williams Odom, FNP
• Emma Odotei, LCSW

• Licensed Practical Nurse in Dublin, GA
• Providers in Dublin, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.