Individual
SRUTTE PANTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3151 ROYAL CREEK WAY SW, LILBURN, GA 30047-1884
(404) 345-4420
Mailing address
3151 ROYAL CREEK WAY SW, LILBURN, GA 30047-1884
(404) 345-4420
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN267277
GA
Other
Enumeration date
10/10/2023
Last updated
01/02/2024
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