Individual
MRS. BRANDIE ANN VILLANOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
130 ENTERPRISE PKWY, MCDONOUGH, GA 30253-9000
(678) 583-9071
Mailing address
130 ENTERPRISE PKWY, MCDONOUGH, GA 30253-9000
(678) 583-9071
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN215790
GA
Other
Enumeration date
09/17/2019
Last updated
09/17/2019
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