Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Nov 17, 2010
License(s)
RN243427 (GA), ARNP9194072 (FL), RN243427 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 6175 NEWTON DR NE | Covington, GA 30014-2690 | 678-342-6000 |
| MAILING | 1105 E KENNEDY BLVD | Tampa, FL 33602-3511 | 813-307-8064 |
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