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Individual

MRS. SUSAN R COLGROVE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1805 VERNON RD, SUITE B, LAGRANGE, GA 30240-4041
(706) 884-2691
(706) 845-7314
Mailing address
1805 VERNON RD, SUITE B, LAGRANGE, GA 30240-4041
(706) 884-2691
(706) 845-7314

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN019428 NP
GA

Other

Enumeration date
01/19/2006
Last updated
07/08/2007
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