| NPI | 1538238837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACIE M NELSON Np 770-739-9555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN129463NP) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |