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Medical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1174904106

Individual Registrant:
Gender: F
Not Sole Proprietor

Location and contact information for practice:
Tel: 770-761-7260  Fax: --

Contact information for business:
Tel: 404-419-1165  Fax: 404-419-1164

Registration Information:
NPI: 1174904106
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant

Legacy codes, insurance codes and state license numbers:



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