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Individual

MR. TERRY ANTHONY HACKWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSN/MBA, NP-C

Contact information

Practice address
2140 PEACHTREE RD NW STE 232, ATLANTA, GA 30309
(404) 231-4431
(404) 231-5677
Mailing address
2140 PEACHTREE RD NW STE 232, ATLANTA, GA 30309-1316
(404) 231-4431
(404) 231-5677

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN143003
GA

Other

Enumeration date
01/31/2012
Last updated
02/19/2019
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