Individual
TAIYE ENADEGHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5173 ROSEWOOD PL, FAIRBURN, GA 30213-5116
(770) 217-0922
(866) 277-9769
Mailing address
5173 ROSEWOOD PL, FAIRBURN, GA 30213-5116
(770) 217-0922
(866) 277-9769
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN294155
GA
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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