Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Pediatrics
Enumerated
Apr 27, 2011
License(s)
APRN-1115 (HI), 1115 (HI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2416 CAPSTONE CT | Columbus, GA 31909-2795 | 706-327-1281 |
| MAILING | 5538 ROARING BRANCH RD | Columbus, GA 31904-2830 |
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