Individual
NATALI N/A GAVRIELOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5913 RUE VILLA LN, TUCKER, GA 30084-1964
(770) 846-5718
Mailing address
5913 RUE VILLA LN, TUCKER, GA 30084-1964
(770) 846-5718
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
RN290310
GA
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
APRN-NP290310
GA
Other
Enumeration date
04/11/2024
Last updated
02/02/2026
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