Individual
ALLYSON BLUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7870 WATERLACE DR, FAIRBURN, GA 30213-4647
(404) 542-5017
Mailing address
7870 WATERLACE DR, FAIRBURN, GA 30213-4647
(404) 542-5017
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
RN086104
GA
163WH0200X
Home Health Registered Nurse
RN086104
GA
163WI0500X
Infusion Therapy Registered Nurse
RN086104
GA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN086104
GA
363LG0600X
Gerontology Nurse Practitioner
RN086104
GA
Other
Enumeration date
04/30/2019
Last updated
03/31/2022
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