Individual
FARDOWSA O KHALIF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2212
(614) 226-9954
Mailing address
1130 N JAMESTOWN RD APT 506, DECATUR, GA 30033-7121
(614) 226-9954
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
RN316591
GA
363LA2100X
Acute Care Nurse Practitioner
APRN.CNP.025806
OH
Other
Enumeration date
01/25/2020
Last updated
03/13/2023
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