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Individual

SUSANNA HAMMONTREE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
GNP-BC, ANP-BC

Contact information

Practice address
1990 LAKESIDE PKWY, SUITE 170, TUCKER, GA 30084-5884
(770) 938-1757
Mailing address
1990 LAKESIDE PKWY, SUITE 170, TUCKER, GA 30084-5884

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN142781
GA

Other

Enumeration date
06/06/2012
Last updated
06/06/2012
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