NPI age
19 years
Enumerated 2006-12-02
Across 950 active nurse practitioner providers in Georgia.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 03507703 | AMERIGROUP |
| 05 (GA) | 42475867AJ | |
| 05 (GA) | 424758676AH | |
| 05 (GA) | 42475867AK |
Part of a multi-provider practice. 10 other active providers share this practice address in NPPES.
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