| NPI | 1053715615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH BRATTON Chief Operating Officer 404-822-5378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363A00000X Physician Assistant | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2014-10-10 |