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Individual

REGINA PEAVY WILEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
424 DECATUR ST SE, ATLANTA, GA 30312-1848
(678) 843-8600
Mailing address
424 DECATUR ST SE, ATLANTA, GA 30312-1848
(678) 843-8600

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN247535
GA

Other

Enumeration date
11/09/2023
Last updated
11/09/2023
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