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Individual

MARISSA MARIE GALAN RAVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1365 ROCK QUARRY RD STE 202, STOCKBRIDGE, GA 30281-5023
(770) 771-6580
(770) 771-6589
Mailing address
1365 ROCK QUARRY RD STE 202, STOCKBRIDGE, GA 30281-5023
(770) 771-6580
(770) 771-6589

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN268489
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN268489
STATE LICENSE #
GA
Enumeration date
08/26/2020
Last updated
10/17/2025
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