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DALLAS LOUIS FNP-C

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1477176600

Individual Registrant:
 DALLAS  LOUIS FNP-C
Gender: F
Not Sole Proprietor

Location and contact information for practice:
11 CHARLIE MORRIS RD  COLBERT, GA 30628-2445 US
Tel: 706-788-3234  Fax: 706-788-2936

Contact information for business:
PO BOX 459  COLBERT, GA 30628-0459 US
Tel: --  Fax: --

Registration Information:
NPI: 1477176600
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
GARN250305

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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