Individual
STEPHANIE NAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
275 COLLIER RD NW STE 300, ATLANTA, GA 30309-1740
(404) 350-0009
Mailing address
2067 SOMERVALE CT NE, BROOKHAVEN, GA 30329-1686
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10912
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/29/2019
Last updated
04/05/2022
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