Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Pediatrics
Enumerated
Mar 3, 2021
License(s)
RN270108 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1526 PARK CREEK CV NE | Brookhaven, GA 30319-2146 | 512-963-4166 |
| MAILING | 1526 PARK CREEK CV NE | Brookhaven, GA 30319-2146 |
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