NPI age
18 years
Enumerated 2007-06-21
Across 3206 active nurse practitioner providers in Georgia.
5 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (IL) | 209002801 | STATE LICENSE |
| 05 (SC) | NP0652 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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