Individual
MRS. ENAS BASHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1412 MILSTEAD AVE NE, CONYERS, GA 30012-3877
(404) 605-2800
Mailing address
1371 SONOMA DR, LAWRENCEVILLE, GA 30045-7833
(404) 252-0256
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
217282
GA
Other
Enumeration date
03/06/2018
Last updated
02/19/2020
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