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Individual

MARY VESSEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
2900 CHAMBLEE TUCKER RD BLDG 16, ATLANTA, GA 30341-4148
(770) 939-1288
Mailing address
652 ORMEWOOD AVE SE, ATLANTA, GA 30312-3618
(404) 759-5262

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN165645
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003214635A
GA
Enumeration date
11/21/2018
Last updated
07/15/2022
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