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Individual

EPTESAM SUFIYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
1700 MEDICAL WAY, SNELLVILLE, GA 30078-2195
(478) 464-8134
Mailing address
46 DARCEE CT, LAWRENCEVILLE, GA 30046-7401

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN287246
GA

Other

Enumeration date
07/15/2022
Last updated
10/05/2023
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