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Individual

ARIDIA I ENNEVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6853 DOUGLAS BLVD STE B, DOUGLASVILLE, GA 30135-7178
(770) 288-0926
Mailing address
3471 HOLLOW STREAM TRL, POWDER SPRINGS, GA 30127-5318
(516) 852-5290

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
185248
GA

Other

Enumeration date
10/04/2023
Last updated
10/04/2023
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