Organization
A PLACE LIKE HOME RESPITE CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY A WILKERSON JR. AGACNP-BC (PROVIDER/OWNER)
(678) 468-8672
Entity
Organization
Contact information
Practice address
1269 NATHAN MAULDIN DR, LAWRENCEVILLE, GA 30043-7249
(470) 263-2806
(802) 365-8491
Mailing address
1269 NATHAN MAULDIN DR, LAWRENCEVILLE, GA 30043-7249
(470) 263-2806
(802) 365-8491
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/08/2023
Last updated
12/08/2023
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