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Individual

SRIVIDYA GANESH IYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
73 PRESTIGE LN STE 103, DAWSONVILLE, GA 30534-6370
(706) 265-8002
Mailing address
4430 SAINT ANDREWS CREST DR, CUMMING, GA 30040-9364
(864) 363-1046

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
APRN-NP240200
GA
363LG0600X
Gerontology Nurse Practitioner
Primary
RN240200
GA

Other

Enumeration date
03/16/2022
Last updated
12/03/2025
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