Individual
KATHALINA VERSHELLE LACOSTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5049 HIGHLAND HILLS PKWY, STONE MOUNTAIN, GA 30088-3740
(678) 777-5995
Mailing address
5049 HIGHLAND HILLS PKWY, STONE MOUNTAIN, GA 30088-3740
(678) 777-5995
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
114591
GA
Other
Enumeration date
03/27/2007
Last updated
10/05/2010
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