Organization
GRANDS PREMIER HEALTH & LAB DIAGNOSTICS LLC
Active
Organization
GRANDS PREMIER HEALTH & LAB DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANTEL ANTOIN BROWN FNP (OWNER)
(770) 990-4699
Entity
Organization
Contact information
Practice address
3347 SURVEYOR CT, DOUGLASVILLE, GA 30135-8102
(770) 990-4699
Mailing address
3347 SURVEYOR CT, DOUGLASVILLE, GA 30135-8102
(770) 990-4699
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
261Q00000X
Clinic/Center
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
01/24/2022
Last updated
02/16/2022
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