Individual
STEPHANIE EVANS WELLBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1800 NORTHSIDE FORSYTH DR STE 450, CUMMING, GA 30041
(770) 444-2191
Mailing address
1800 NORTHSIDE FORSYTH DR STE 450, CUMMING, GA 30041-8483
(770) 444-2191
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
007185
GA
Other
Enumeration date
07/07/2014
Last updated
01/25/2019
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