| NPI | 1043860554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA RENEE LITTLES Nurse Practitioner 770-374-7062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2022-07-18 |