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Individual

WHITNEY MARIE MIGHTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
727 WILDWOOD GLN, VILLA RICA, GA 30180-2428
(470) 651-2821
Mailing address
727 WILDWOOD GLN, VILLA RICA, GA 30180-2428

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0014222069
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00998966
GA
Enumeration date
09/03/2021
Last updated
09/03/2021
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