NPI | 1376145318 |
---|---|
Entity Type | Organization |
Authorized Contact | ANTRANIKA D. ROSS Nurse Practitioner 678-749-5702 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
363LG0600X Nurse Practitioner, Gerontology | |
Enumeration Date | 2020-11-13 |
Last Update Date | 2022-09-07 |