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Individual

CATHERINE R BOMAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
1100 LAKE HEARN DRIVE, STE 450, ATLANTA, GA 30342
(404) 252-7339
(404) 257-0337
Mailing address
1100 LAKE HEARN DRIVE, STE 450, ATLANTA, GA 30342
(404) 252-7339
(404) 257-0337

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R077495
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000487099A
GA
Enumeration date
06/07/2006
Last updated
05/22/2012
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