Individual
DIANE H COUSINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1610 10TH ST, CLARK-HOLDER CLINIC, P.A., WEST POINT, GA 31833
(706) 645-2300
(706) 645-2312
Mailing address
2733 FOREST RD, GREENVILLE, GA 30222-2260
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1-067853
AL
363LF0000X
Family Nurse Practitioner
Primary
RN106393
GA
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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