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Individual
SPRING OU-TIM
Active
Individual
SPRING OU-TIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
RN174096
GA
363L00000X
Nurse Practitioner
Primary
RN174096
GA
363LA2100X
Acute Care Nurse Practitioner
RN174096
GA
363LP0200X
Pediatric Nurse Practitioner
RN174096
GA
Other
Enumeration date
10/26/2018
Last updated
10/12/2024
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