Individual
MS. IRENE STEPHANOPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
615 BEAVER RUIN RD NW STE B, LILBURN, GA 30047-3401
(770) 935-8616
(770) 935-8549
Mailing address
1608 DELANO DR, DECATUR, GA 30032-3338
(770) 935-8616
(770) 935-8549
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN274593
GA
Other
Enumeration date
10/17/2012
Last updated
12/04/2018
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