NPI age
11 years
Enumerated 2014-11-16
Across 8826 active nurse practitioner providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003153964A | |
| 01 (GA) | RN104589 | GEORGIA LICENSE |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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