| NPI | 1962367219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI BRIDGMAN Nurse Practitioner 678-227-2398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202D00000X Integrative Medicine |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2025-12-18 |
| Last Update Date | 2025-12-27 |