Individual
LAURA DEGLER ELLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3200 DOWNWOOD CIR NW STE 550, ATLANTA, GA 30327-1624
(404) 351-0205
(404) 351-4187
Mailing address
3200 DOWNWOOD CIR NW STE 550, ATLANTA, GA 30327-1624
(404) 351-0205
(404) 351-4187
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN138324
GA
363LF0000X
Family Nurse Practitioner
RN138324
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003180783A
—
GA
05
—
003180783C
—
GA
Enumeration date
03/04/2016
Last updated
03/17/2018
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