NPI age
20 years
Enumerated 2005-10-12
Across 8826 active nurse practitioner providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000806649E | |
| 01 | 581719867066 | TRICARE |
Part of a multi-provider practice. 22 other active providers share this practice address in NPPES.
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