# PRESTIGE MEDICAL CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881284511
- **Authorized official:** MRS. CHRISTY DICKERSON AGNP-C (OWNER)
- **Authorized official phone:** (706) 333-9932

## Contact information

- **Practice address:** 4529 STERLING POINTE DR NW, KENNESAW, GA 30152-7321
- **Practice address phone:** (706) 333-9932
- **Mailing address:** PO BOX 1712, KENNESAW, GA 30156-8712

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/26/2021
- **Last updated:** 01/26/2021