Individual
MRS. OCTAVIA MOORE HEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1707 BLAIR BRIDGE RD, AUSTELL, GA 30168-5537
(678) 945-0700
Mailing address
8601 BALDWIN PKWY STE 100, DOUGLASVILLE, GA 30134-5626
(678) 948-8753
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
RN-147913-NP
GA
Other
Enumeration date
10/01/2019
Last updated
11/29/2019
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