Individual
ANNA LEIGH VONCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6300 HOSPITAL PKWY STE 100, DULUTH, GA 30097-1829
(707) 716-5917
Mailing address
6300 HOSPITAL PKWY STE 100, DULUTH, GA 30097-1829
(770) 771-6591
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
025874
NY
363A00000X
Physician Assistant
Primary
11341
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025874
OFFICE OF THE PROFESSIONS LICENSURE/REGISTRATION NUMBER
NY
01
—
1177899
NCCPA CERTIFICATION NUMBER
—
Enumeration date
11/04/2020
Last updated
05/11/2023
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