Individual
NICKOLA FANCINE BOOKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2324 LIMESTONE OVERLOOK, GAINESVILLE, GA 30501-7443
(770) 536-8109
(770) 536-3203
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004733
GA
Other
Enumeration date
05/10/2006
Last updated
12/07/2020
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