Individual
OMOYEME ALICESON EHIZUELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP-BC
Contact information
Practice address
680 HILLCREST RD NW STE 400, LILBURN, GA 30047-6898
(404) 566-8045
(404) 999-6787
Mailing address
1700 NORTHSIDE DRIVE NW, SUITE A7 PMB 2078, ATLANTA, GA 30318
(404) 566-8045
(404) 999-6787
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
313937
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN313937
GA
Other
Enumeration date
07/22/2022
Last updated
08/07/2024
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