Georgia Phs Llc

NPI 1043605314 - Nurse Practitioner - 363LA2200X

NPI Details
NPI 1043605314
Enumeration Date 04/02/2015
Last Updated 04/06/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name NICOLE NICOLE
Position CEO
Phone (337) 991-9276
Fax (337) 991-9288
Practice Location
3355 LENOX RD NE
SUITE 750
ATLANTA GA, 30326-1394, US
Phone (337) 991-9276
Fax (337) 991-9288
Business Location
1509 DULLES DR
LAFAYETTE LA, 70506-3718, US
Phone (337) 991-9276
Fax (337) 991-9288
Toxanomy
Taxonomy Code 363LA2200X
License State
License Number
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According to our database, Georgia Phs Llc NPI is 1043605314, taxonomy code is 363LA2200X Georgia Phs Llc physically located at 3355 Lenox Rd Ne, Atlanta GA, 30326-1394. NPI Number 1033115704 has the healthcare provider type.

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1043605314 NPI number is provided on an as is basis without warranty of any kind. 1043605314 is maintained by the National Plan & Provider Enumeration System. The contents of Georgia Phs Llc are for informational purposes only.