| NPI | 1710554464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYONA J MORELAND Owner 770-648-2148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2024-02-09 |