Organization
GOODLIFE CARDIAC CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAQUETA NELSON NP (OWNER/PROVIDER)
(770) 383-1415
Entity
Organization
Contact information
Practice address
2400 HERODIAN WAY SE STE 220, SMYRNA, GA 30080-8500
(770) 383-1415
Mailing address
2400 HERODIAN WAY SE STE 220, SMYRNA, GA 30080-8500
(770) 383-1415
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/02/2022
Last updated
12/02/2022
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