Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Aug 3, 2021
License(s)
RN173191 (GA), RN173191 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1619 MAYBELL TRL | Lawrenceville, GA 30044-2074 | 908-616-1359 |
| MAILING | 1619 MAYBELL TRL | Lawrenceville, GA 30044-2074 | 908-616-1359 |
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