NPI age
19 years
Enumerated 2006-09-26
Across 8826 active nurse practitioner providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | RN129528 | RN LICENSE-CNM |
| 05 (GA) | 00912832A | |
| 01 | 0360295 | FNP CERT. 9/2006-8/2011 |
| 01 | 10265 | ACNM CERTIFICATION NUMBER |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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