Individual
MS. DOROTHY DELISFORT-CRISOSTOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4228 1ST AVE STE 1, TUCKER, GA 30084-4426
(833) 583-4778
(833) 583-4779
Mailing address
4228 1ST AVE STE 1, TUCKER, GA 30084-4426
(833) 583-4778
(833) 583-4779
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
RN141244
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN141244
GA
Other
Enumeration date
11/28/2016
Last updated
04/15/2024
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