Individual
MRS. PREM LATA KHANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
445 WINN WAY, DECATUR, GA 30030-1707
(404) 508-7793
(404) 508-7860
Mailing address
368 BROOKSHIRE DR SW, LILBURN, GA 30047-2106
(770) 389-8817
(404) 508-7860
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN080496
GA
Other
Enumeration date
09/14/2012
Last updated
09/14/2012
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