Individual
MALLORY STAVRINAKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1405 CLIFTON RD NE, ATLANTA, GA 30322-1060
(262) 483-1580
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN253137
GA
363L00000X
Nurse Practitioner
Primary
5014947
NC
Other
Enumeration date
03/20/2019
Last updated
04/28/2022
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