Individual
MRS. NATISHA LATRISE ROBERSON-DUNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
195 FAIRVIEW RD, ELLENWOOD, GA 30294-2722
(770) 507-0112
Mailing address
15 COBBLESTONE DR, NEWNAN, GA 30265-6047
(770) 304-3932
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004412
GA
Other
Enumeration date
12/22/2007
Last updated
12/22/2007
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