Individual
MRS. PETA-GAYE C PILOTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
319 REGAL WAY E, MCDONOUGH, GA 30253
(678) 559-2488
Mailing address
319 REGAL WAY E, MCDONOUGH, GA 30253-8248
(678) 559-2488
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
RN249535
GA
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
PCH007436
GA
Other
Enumeration date
08/29/2018
Last updated
08/29/2018
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