Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Oct 5, 2018
License(s)
24762 (TN), RN202374 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 118 E GIRARD AVE | Cedartown, GA 30125-2712 | 678-246-5174 |
| MAILING | 200 W MARTIN LUTHER KING BLVD STE 1000 | Chattanooga, TN 37402-2571 | 423-269-2255 |
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