NPI age
19 years
Enumerated 2007-05-16
Across 8826 active nurse practitioner providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 715148338A | |
| 01 (GA) | 11D0941435 | CLIA ID |
| 01 (GA) | 385393 | WELLCARE OF GEORGIA |
| 01 (GA) | RN10167 | GEORGIA LICENSE |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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