| NPI | 1114303567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELLA DININA GREEN Owner 404-452-2519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: GA 186231) |
| Enumeration Date | 2015-08-08 |
| Last Update Date | 2023-12-18 |