KATHRYN DELUISE LICCARDO

BUFORD, GA
NPI1497380497
Former NameKATHRYN LOUISE DELUISE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0200X Nurse Practitioner, Pediatrics
(Licence: GA  RN223459)
Enumeration Date2020-03-10
Last Update Date2023-08-17
Business Address
KATHRYN DELUISE LICCARDO CPNP-PC
4095 S LEE ST
BUFORD, GA 30518-3647
Phone number: 770-932-8519
Mailing Address
KATHRYN DELUISE LICCARDO CPNP-PC
PO BOX 658
GAINESVILLE, GA 30503-0658
Phone number: 770-718-1122
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