Individual
BETH DZICZKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
406 KINGS POINT DR, CANTON, GA 30115-5210
(404) 966-9296
Mailing address
406 KINGS POINT DR, CANTON, GA 30115-5210
(404) 966-9296
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN264561
GA
Other
Enumeration date
06/12/2025
Last updated
06/12/2025
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