NPI age
11 years
Enumerated 2014-10-13
Across 8826 active nurse practitioner providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003153996A | |
| 01 | F1014375 | CERTIFICATION |
| 01 (GA) | RN191831 | MEDICAL LICENSE |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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