| NPI | 1093187809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRA JOHNSON Member/Manager 678-281-5523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2015-10-20 |