Individual
LATIFAT BOLAJOKO ASEMOTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
410 NOTTINGHAM DR, MARIETTA, GA 30066
(678) 401-8229
Mailing address
410 NOTTINGHAM DR, MARIETTA, GA 30066-2542
(678) 401-8229
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
218849
GA
363LP2300X
Primary Care Nurse Practitioner
Primary
RN218849
GA
Other
Enumeration date
07/26/2015
Last updated
07/13/2018
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