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Individual

ROSEYLEE KURIAKOSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
367 ATHENS HWY, LOGANVILLE, GA 30052-2204
(678) 466-6760
Mailing address
367 ATHENS HWY, LOGANVILLE, GA 30052-2204

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN220165
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
RN220165
GA
Enumeration date
10/02/2020
Last updated
10/02/2020
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