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Individual

MRS. QUYEN LE TA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
960 JOE FRANK HARRIS PKWY SE, CARTERSVILLE, GA 30120-2129
(470) 490-2142
Mailing address
2628 MYRTLEWOOD LN NW, KENNESAW, GA 30144-7395
(404) 324-9413

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN211447
GA
363LF0000X
Family Nurse Practitioner
RN211447
GA

Other

Enumeration date
05/28/2016
Last updated
09/25/2025
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