Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Pediatrics
Enumerated
Jan 19, 2011
License(s)
688345 (TX), 215132 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 5887 GLENRIDGE DR STE 230 | Sandy Springs, GA 30328-9929 | 470-210-8179 |
| MAILING | 5887 GLENRIDGE DR STE 230 | Sandy Springs, GA 30328-9929 | 470-210-8179 |
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