MIRA DESAI

STONE MOUNTAIN, GA
NPI1538559190
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LG0600X Nurse Practitioner Gerontology
(Licence: IL  277.002161)
Additional Taxonomies363LA2200X Nurse Practitioner Adult Health
(Licence: GA  RN309281)
363LG0600X Nurse Practitioner Gerontology
(Licence: RI  APRN03074)
363LG0600X Nurse Practitioner Gerontology
(Licence: CT  13875)
363LG0600X Nurse Practitioner Gerontology
(Licence: VA  0001299163)
Enumeration Date2015-02-03
Last Update Date2025-06-06
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 746715
ATLANTA, GA 30374-6715
Phone number: 773-352-1515