Individual
NATHAN TRAVIS FANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4550 COBB PARKWAY NORTH NW STE 101, ACWORTH, GA 30101-4181
(770) 917-8140
Mailing address
5629 WOOLWICH LN NW, ACWORTH, GA 30101-6914
(678) 478-7542
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN239986
GA
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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