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Individual provider · Psychiatric/Mental Health Nurse Practitioner · Dallas, GA

NPI
1346871696
Type
Individual (Type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner (Nurse Practitioner)
Specialty group
Physician Assistants & Advanced Practice Nursing Providers
Taxonomy code
363LP0808X
License number
RN243114 (GA)
Sex
Female
Sole proprietor
Yes
Enumerated
2020-01-27
Last updated
2020-01-27
Practice location
108 Crescent Woode Dr
Dallas, GA 30157-5725
(770) 702-5945

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