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1952016396
ERIN BARDONNER SUSTACHEK
CANTON, GA
NPI
1952016396
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Former Name
ERIN MARIE BARDONNER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: GA GAA-NP001149)
Enumeration Date
2023-01-19
Last Update Date
2024-05-02
Business Address
ERIN BARDONNER SUSTACHEK APRN
210 OAKSIDE LN
CANTON, GA 30114-6417
Phone number: 678-807-1050
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Mailing Address
ERIN BARDONNER SUSTACHEK APRN
PO BOX 307
CUMMING, GA 30028-0307
Phone number: 770-887-1668
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