NPI age
19 years
Enumerated 2006-09-17
Across 8826 active nurse practitioner providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | RN060038 | NP LICENSE |
| 05 (GA) | 003130707A | |
| 01 (GA) | 202I508951 | MEDICARE PTAN |
| 05 (GA) | 003130707C |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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