| NPI | 1326480666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE NICOLE WATERS Family Nurse Practitioner 770-679-9935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: GA 206177) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN206177) |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2013-08-26 |