| NPI | 1538755749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABRIA COLSTON Nurse Practitioner 470-631-4035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| Enumeration Date | 2020-12-12 |
| Last Update Date | 2021-04-27 |