Individual
EVAH WANGUNGU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
705 DIXIE ST, CARROLLTON, GA 30117-3818
(770) 838-8824
Mailing address
119 AMBULANCE DR, SUITE 202, CARROLLTON, GA 30117-3857
(770) 838-8824
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN206115
GA
Other
Enumeration date
11/02/2016
Last updated
01/10/2017
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