MIRA DESAI

STONE MOUNTAIN, GA
NPI1538559190
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: GA  RN309281)
Additional Taxonomies363LG0600X Nurse Practitioner, Gerontology
(Licence: VA  0001299163)
363LG0600X Nurse Practitioner, Gerontology
(Licence: RI  APRN03074)
363LP2300X Nurse Practitioner, Primary Care
(Licence: IL  041426832)
Enumeration Date2015-02-03
Last Update Date2024-10-31
Business Address
MIRA DESAI AGPCNP
1825 ROCKBRIDGE RD STE 15B
STONE MOUNTAIN, GA 30087-3306
Phone number: 470-444-3134
Mailing Address
MIRA DESAI AGPCNP
PO BOX 740015
ATLANTA, GA 30374-0015
Phone number: